The product of the ∧0/b （-B/0） differential production cross-section and the branching fraction of the decay ∧0/b→ J/ψ pK-（-B/0→ J/ψ-K＊（892）0）is measured as a function of the beauty hadron transverse mome...The product of the ∧0/b （-B/0） differential production cross-section and the branching fraction of the decay ∧0/b→ J/ψ pK-（-B/0→ J/ψ-K＊（892）0）is measured as a function of the beauty hadron transverse momentum, PT, and rapidity, y. The kinematic region of the measurements is pT〈20 GeV/c and 2.0 〈g〈4.5.The measurements use a data sample corresponding to an integrated luminosity of 3fb-1 collected by the LHCb detector in pp collisions at centre-of-mass energies √s=7 TeV in 2011 and √s=8 TeV in 2012. Based on previous LHCb results of the fragmentation fraction ratio,f∧0/b/fd,the branching fraction of the decay ∧0/b→ J/ψ pK-is measured to be B（∧0/b→ J/ψ pK-）=（3.17±0.04±0.07±0.34＋0.45/-0.28）×10-4,where the first uncertainty is statistical, the second is systematic, the third is due to the uncertainty on the branching fraction of the decay -B/0 →J/ψ-K＊（892）0,and the fourth is due to the knowledge of f∧0/b/fd.The sum of the asymmetries in the production and decay between ∧0/b and ∧0/bis also measured as a function of PT and y.The previously published branching fraction of ∧0/b→ J/ψ pπ-,relative to that of ∧0/b→ J/ψ pK-,is updated. The branching fractions of ∧0/b→P＋c（→ J/ψp）K-are determined.展开更多
AIM To perform a systematic review and meta-analysis on proton pump inhibitors(PPIs) therapy and the risk of Clostridium difficile infection(CDI). METHODS We conducted a systematic search of MEDLINE/Pub Med and seven ...AIM To perform a systematic review and meta-analysis on proton pump inhibitors(PPIs) therapy and the risk of Clostridium difficile infection(CDI). METHODS We conducted a systematic search of MEDLINE/Pub Med and seven other databases through January 1990 to March 2017 for published studies that evaluated the association between PPIs and CDI. Adult case-control and cohort studies providing information on the association between PPI therapy and the development of CDI were included. Pooled odds ratios(ORs) estimates with 95% confidence intervals(CIs) were calculated using the random effect. Heterogeneity was assessed by I^2 test and Cochran's Q statistic.Potential publication bias was evaluated via funnel plot, and quality of studies by the Newcastle-Otawa Quality Assessment Scale(NOS). RESULTS Fifty-six studies(40 case-control and 16 cohort) involving 356683 patients met the inclusion criteria and were analyzed. Both the overall pooled estimates and subgroup analyses showed increased risk for CDI despite substantial statistical heterogeneity among studies. Meta-analysis of all studies combined showed a significant association between PPI users and the risk of CDI(pooled OR = 1.99, CI: 1.73-2.30, P < 0.001) as compared with non-users. The association remained significant in subgroup analyses: by design-case-control(OR = 2.00, CI: 1.68-2.38, P < 0.0001), and cohort(OR = 1.98, CI: 1.51-2.59, P < 0.0001); adjusted(OR = 1.95, CI: 1.67-2.27, P < 0.0001) and unadjusted(OR = 2.02, CI: 1.41-2.91, P < 0.0001); unicenter(OR = 2.18, CI: 1.72-2.75, P < 0.0001) and multicenter(OR = 1.82, CI: 1.51-2.19, P < 0.0001); age ≥ 65 years(OR = 1.93, CI: 1.40-2.68, P < 0.0001) and < 65 years(OR = 2.06, CI: 1.11-3.81, P < 0.01). No significant differences were found in subgroup analyses(test for heterogeneity): P = 0.93 for case-control vs cohort, P = 0.85 for adjusted vs unadjusted, P = 0.24 for unicenter vs multicenter, P = 0.86 for age ≥ 65 years and < 65 years. There was significant heterogeneity across studies(I^2 = 85.4%, P < 0.00展开更多
Although a considerable number of studies support a substantial increase in incidence, severity, and healthcare costs for Clostridium difficile infection (CDI) in inflammatory bowel disease (IBD), only few evaluate it...Although a considerable number of studies support a substantial increase in incidence, severity, and healthcare costs for Clostridium difficile infection (CDI) in inflammatory bowel disease (IBD), only few evaluate its impact on IBD outcome. Medline and several other electronic databases from January 1993 to October 2013 were searched in order to identify potentially relevant literature. Most of the studies showed that IBD patients with CDI present a greater proportion of worse outcomes than those without CDI. These patients have longer length of hospital stay, higher rates of colectomies, and increased mortality. Patients with ulcerative colitis are more susceptible to CDI and have more severe outcomes than those with Crohn’s disease. However, studies reported variable results in both short- and long-term outcomes. Contrasting results were also found between studies using nationwide data and those reporting from single-center, or between some North-American and European studies. An important limitation of all studies analyzed was their retrospective design. Due to contrasting data often provided by retrospective studies, further prospective multi-center studies are necessary to evaluate CDI impact on IBD outcome. Until then, a rapid diagnosis and adequate therapy of infection are of paramount importance to improve IBD patients’ outcome. The aim of this article is to provide up to date information regarding CDI impact on outcome in IBD patients.展开更多
The evolution of the individual in ontogenesis has been studied throughout life and on all sides of development. Studies in the field based on medical rehability performed by a full team such as doctors, physiotherapi...The evolution of the individual in ontogenesis has been studied throughout life and on all sides of development. Studies in the field based on medical rehability performed by a full team such as doctors, physiotherapists and psychologists and not only have shown that the link between the patient’s psychological state and exercise are factors in full dependence and any imbalance can trigger irreparable effects. Psychology is the science that studies the laws of formation, development, functioning and deficiencies related to psychism;it includes a series of fundamental concepts that include: psychic processes, psychic phenomena, psychic attributes, psychic states or psychic activities. Psychic phenomena are the component elements of psychism. In a sense, the psychic phenomena are manifested by external facts, by our behavior, by the motor actions started, by gestures or verbal actions;in the other sense, psychic phenomena are manifested by inner deeds, as the form of ideas, images, feelings, and desires. The motor acts without psychism would be only simple automatisms, without human specifications of adaptation, while the psychism without motor acts would be deprived of the fundamentals of formation and functioning as well as of its production mechanisms. Objective: The objective of this study is to highlight the causal problems of delayed medical recovery in relation to the psychological and emotional factors. This desktop review aims to identify psychoemotional disorders in the case of subjects with operated lumbar disc herniation and aims to adapt a specialized physiotherapeutic protocol by adapting to CIF. The result of this study will be found in the percentage of socio-professional reintegration of the subjects with operated lumbar disc herniation and implicitly the increase in the quality of life. Conclusions: 1) For an effective functional recovery, a psycho-emotional balance is needed;2) A positive attitude actively influences medical rehabilitation;3) Regaining physical, cognitive and social activities 展开更多
Current researches reveal that the number of cases diagnosed with operated lumbar disc herniation is growing rapidly, which should draw an increased attention to the treatment used. The objective of this study is to p...Current researches reveal that the number of cases diagnosed with operated lumbar disc herniation is growing rapidly, which should draw an increased attention to the treatment used. The objective of this study is to perform a comparative analysis between the application of a classical physical-kinetic program and the application of a combined kinetic program. This research will be conducted on 20 subjects with ages, between 40 - 50 years old, in INEMRCM Bucharest, for 14 days - 1 hour a day. Each subject underwent an invasive surgery for lumbar disc herniation on the L5-S1 vertebrae. During the research, the 2 patients will be given a physical-kinetic program, adapted to the pathology of the operated lumbar disc herniation. The purpose of this research is to check the efficiency of each kinetic program. Furthermore, through the muscular and articular evaluation made in the initial phase and the final phase, it will be possible to discuss the comparative evolution of the established kinetic program and the functional gain obtained. In conclusion, the research shows that mechanized therapy results in faster functional rehabilitation and physical exercise substantially improves quality of life.展开更多
Background and Aims: Several studies have shown that hypoglycaemia, especially a severe episode is associated with an increased mortality rate in diabetes mellitus subjects with previous cardiovascular disease or acut...Background and Aims: Several studies have shown that hypoglycaemia, especially a severe episode is associated with an increased mortality rate in diabetes mellitus subjects with previous cardiovascular disease or acute coronary syndrome. One of the presumed mechanisms is the proarrhythmic effect of hypoglycaemia related to the prolongation of the action potential, or the catecholamine surge that follows an episode. The aim of this case series analysis was to investigate the relationship between hypoglycaemia and glucose variability with arrhythmic events in type 2 diabetes patients who suffered an acute myocardial infarction. Materials and Methods: We selected patients admitted consecutively to the cardiology department of Clinical Emergency Hospital in Bucharest for a period of three months with acute myocardial infarction and previously diagnosed type 2 diabetes. For each patient, a retrospective continuous glucose monitoring system (CGMS) or glucose sensor (Medtronic<sup>®</sup> Enlite, USA) and a dual electrocardiograph and blood pressure monitor for 24 hours were available. Also, patients had an oscillometric device (Arteriograph<sup>®</sup> TensioMed Ltd) for 24 hours or non-invasive monitoring of central blood pressure, pulse wave velocity and augmentation index. The data were analysed using Medtech<sup>®</sup>, TensioWin<sup>®</sup> and Carelink iPro<sup>®</sup> softwares. We used SPSS<sup>®</sup> version 20.0 (IBM) for the statistical analysis. The results are presented as median and interquartile range (IQR). Results and Discussion: Ten type 2 diabetes patients (4 males, 6 females) with anterior (4/10) and inferior acute myocardial infarction (6/10) were included. They were treated with insulin (3/10), sulphonylurea (Gliclazide) plus Metformin (4/10), Metformin monotherapy (2/10), or all three (1/10). The patients had a median age of 67.5 (3.25) years with a median disease duration of 8 (7.75) years. The median body mass index was 29.54 (5.65) kg/m<sup>2</sup>. The median HbA1c w展开更多
A series of events relating to inferior medical devices has brought about changes in the legal requirements regarding quality control on the part of regulators. Apart from clinical studies, register and routine data w...A series of events relating to inferior medical devices has brought about changes in the legal requirements regarding quality control on the part of regulators. Apart from clinical studies, register and routine data will play an essential role in this context. To ensure adequate use of these data, adapted methodologies are required as register data in fact represent a new scientific entity. For the interpretation of register and routine data several limitations of published data should be taken into account. In many cases essential parameters of study cohorts- such as age, comorbidities, the patients' risk profiles or the hospital profile- are not presented. Required data and evaluation procedures differ significantly, for example, between hip and spine implants. A "one fits for all" methodology is quite unlikely to exist and vigorous efforts will be required to develop suitable standards in the next future. The new legislation will affect all high-risk products, besides joint implants also contact lenses, cardiac pacemakers or stents, for example, the new regulations can markedly enhance product quality monitoring. Register data and clinical studies should not be considered as competitors, they complement each other when used responsibly. In the future follow-up studies should increasingly focus on specific questions, while global follow-up investigations regarding product complication rates and surgical methods will increasingly be covered by registers.展开更多
Background After minimally invasive repair for pectus excavatum (MIRPE), similar procedures for pectus carinatum were developed. This study aimed to analyse the various published techniques of minimal access repair fo...Background After minimally invasive repair for pectus excavatum (MIRPE), similar procedures for pectus carinatum were developed. This study aimed to analyse the various published techniques of minimal access repair for pectus carinatum (MARPC) and compare the outcomes. Data sources Literature was reviewed on PubMed with the terms 'pectus carinatum', 'minimal access repair', 'thoracos-copy' and 'children'. Results Twelve MARPC techniques that included 13 articles and 140 patients with mean age 15.46 years met the inclusion criteria. Success rate of corrections wasn = 125, about 89% in cumulative reports, with seven articles reporting 100%. The complication rate was 39.28%. Since the pectus bar is placed over the sternum and has a large contact area, skin irritation was the most frequent morbidity (n = 20, 14.28%). However, within the complication group (n = 55), wire breakage (n = 21, 38.18%) and bar displacement (n = 10, 18.18%) were the most frequent complications. Twenty-two (15.71%) patients required a second procedure. Recurrences have been reported in four of twelve techniques. There were no lethal outcomes. Conclusions MARPC techniques are not standardized, as MIRPE are, so comparative analysis is difficult as the only common denominator is minimal access. Surgical morbidity is high in MARPC and affects > 2/3rd patients with about 15% requiring surgery for complication management.展开更多
BACKGROUND Patients with primary sclerosing cholangitis(PSC)are at a high risk of developing cholestatic liver disease and biliary cancer,and endoscopy is crucial for the complex management of these patients.AIM To cl...BACKGROUND Patients with primary sclerosing cholangitis(PSC)are at a high risk of developing cholestatic liver disease and biliary cancer,and endoscopy is crucial for the complex management of these patients.AIM To clarify the utility of recently introduced digital single-operator video cholangioscopy(SOVC)for the endoscopic management of PSC patients.METHODS In this observational study,all patients with a history of PSC and in whom digital SOVC(using the SpyGlass DS System)was performed between 2015 and 2019 were included and retrospectively analysed.Examinations were performed at a tertiary referral centre in Germany.In total,46 SOVCs performed in 38 patients with a history of PSC were identified.The primary endpoint was the evaluation of dominant biliary strictures using digital SOVC,and the secondary endpoints were the performance of selective guidewire passage across biliary strictures and the diagnosis and treatment of biliary stone disease in PSC patients.RESULTS The 22 of 38 patients had a dominant biliary stricture(57.9%).In 4 of these 22 patients,a cholangiocellular carcinoma was diagnosed within the stricture(18.2%).Diagnostic evaluation of dominant biliary strictures using optical signs showed a sensitivity of 75%and a specificity of 94.4%to detect malignant strictures,whereas SOVC-guided biopsies to gain tissue for histopathological analysis showed a sensitivity of 50%and a specificity of 100%.In 13%of examinations,SOVC was helpful for guidewire passage across biliary strictures that could not be passed by conventional methods(technical success rate 100%).Biliary stone disease was observed in 17.4%of examinations;of these,in 37.5%of examinations,biliary stones could only be visualized by SOVC and not by standard fluoroscopy.Biliary stone treatment was successful in all cases(100%);25%required SOVC-assisted electrohydraulic lithotripsy.Complications,such as postinterventional cholangitis and pancreatitis,occurred in 13%of examinations;however,no procedure-associated mortality occurred.CONCLUSION Digit展开更多
We report on the use of a fiber-based Mueller-matrix optical coherence tomography(OCT)system with continuous source-polarization modulation for in vivo imaging of early stages of skin cancer in SENCAR mice.A homemade ...We report on the use of a fiber-based Mueller-matrix optical coherence tomography(OCT)system with continuous source-polarization modulation for in vivo imaging of early stages of skin cancer in SENCAR mice.A homemade hand-held probe with integrated optical scanning and beam delivering optics was coupled in the sample arm.The OCT images show the morphological changes in skin resulting from pre-cancerous papilloma formations that are consistent with histology,thus demonstrating the system’s potential for early skin cancer detection.展开更多
This article aims to study the indicators used in the financial analysis for credit and explain them. Also it checks the impact of each indicator in credit analysis and what happens if the pointer is changed deliberat...This article aims to study the indicators used in the financial analysis for credit and explain them. Also it checks the impact of each indicator in credit analysis and what happens if the pointer is changed deliberately to get the loan, giving some possible ways to do it and analyzing them. It proposes a new model to evaluate the indicators and the assignment of weights in formula evaluation of each indicator, so the risks of granting credit will be smaller as well as the evaluation of the financial terms of a company will be more balanced and optimal. The scope is to equilibrate the weights of each indicator in the fmancial credit analyze not by rescoring its value but by assigning shares in the evaluation formula. Doing this, it can be considered as a double checking using the same parameters and it lowers the risks in the money recovering. As it is debated in the article anyone can do fxaud to obtain a loan by altering the documents they provide through which some can do it good and even get uncaught. The scope is not to find what they did; it is to get protected even if they do it.展开更多
Einstein＇s equation,in its standard form,breaks down at the Big Bang singularity.A new version,equivalent to Einstein＇s whenever the latter is defined,but applicable in wider situations,is proposed.The new equation ...Einstein＇s equation,in its standard form,breaks down at the Big Bang singularity.A new version,equivalent to Einstein＇s whenever the latter is defined,but applicable in wider situations,is proposed.The new equation remains smooth at the Big Bang singularity of the Friedmann-Lemaatre-Robertson-Walker model.It is a tensor equation defined in terms of the Ricci part of the Riemann curvature.It is obtained by taking the Kulkarni-Nomizu product between Einstein＇s equation and the metric tensor.展开更多
We solve two Markowitz optimization problems for the one-step financial model with a finite number of assets. In our results, the classical (inefficient) constraints are replaced by coherent measures of risk that are ...We solve two Markowitz optimization problems for the one-step financial model with a finite number of assets. In our results, the classical (inefficient) constraints are replaced by coherent measures of risk that are continuous from below. The methodology of proof requires optimization techniques based on functional analysis methods. We solve explicitly both problems in the important case of Tail Value at Risk.展开更多
Removal of foreign bodies from seed mixtures, or their calibration for use as planting material, as well as fraction classification of granular materials requires screening surfaces with vibratory motion. This paper p...Removal of foreign bodies from seed mixtures, or their calibration for use as planting material, as well as fraction classification of granular materials requires screening surfaces with vibratory motion. This paper presents some aspects on the working process of a sieve, made of perforated sheet and having an outer conical surface with oscillatory circular motion （alternative） on the horizontal. Results are presented for some experimental researches on the movement of material on the sieve, for various kinematical parameters of the sieve （amplitude and oscillation frequency）. A conical sieve, suspended at the upper and lower in three points, was tested for screening of rapeseeds in order to estimate the influence of oscillation frequency on the screening process. Curves were drawn for separation intensity on the sieve generating line, and by regression analysis with normal distribution law were determined the equation coefficients and the correlation with experimental data. Movement of material on the sieve and its working process, in general, was appreciated by means of the peak position of distribution curve depending on the oscillation frequency of the sieve, considering that the normal distribution law correlates very well the data obtained by experiments.展开更多
Study of neutrino properties is nowadays one of the most active domains of research in physics. On the one hand, fundamental properties of the neutrinos like their absolute mass, their character (are they Dirac or Maj...Study of neutrino properties is nowadays one of the most active domains of research in physics. On the one hand, fundamental properties of the neutrinos like their absolute mass, their character (are they Dirac or Majorana particles?) and the number of neutrino flavors, are still unknown. On the other hand, the knowledge of these properties are of great importance since the neutrinos are very abundant in nature and play a key role in nuclear and particle physics, astrophysics and cosmology. In addition, the results of the neutrino oscillation experiments have convincingly showed that neutrinos have mass and mix, in contradiction to the initial assumptions of the Standard Model. In this context there is an increased interest in the study of the Lepton Number Violating (LNV) processes, since they are capable to decide on the above mentioned neutrino properties. Since recently, the neutrinoless double beta (0nββ) decay was considered the only process able to distinguish between Dirac or Majorana neutrinos and to give a hint on the absolute mass of the electron neutrino. At present, the increased luminosity of the LHC experiments at CERN makes it feasable the search for LNV processes at LHC as well. Besides the neutrino character, these studies can also shed light on the existence of other types of neutrinos (the sterile neutrinos), than the three known ones. In this paper, I make a brief review on our present knowledge about the neutrino properties and on the way they can be probed by LNV processes at low- and high-energies. Particularly, I refer to the 0nββ decay process and to the first attempts of searching of LNV processes in hadron collider experiments, particularly in LHC experiments at CERN-Geneva.展开更多
Objectives: Experimental and clinical data suggest that brain death predominantly affects the right ventricle. We aimed to investigate right ventricle function after brain death and during clinical transplantation wit...Objectives: Experimental and clinical data suggest that brain death predominantly affects the right ventricle. We aimed to investigate right ventricle function after brain death and during clinical transplantation with load-independent methods. Methods: Patients with and without brain death were enrolled. A total of 33 consecutive heart donors(5 live, “domino”donors)and 10 patients undergoing coronary surgery(coronary artery bypass graft controls) were studied with pressure-volume loops in the right ventricle. Contractile reserve was measured with dopamine stimulation. Results: Brain-dead donors had a higher mean cardiac index than coronary artery bypass graft controls(3.3 vs 2.8 L/min/m2), but impaired load-independent indices. Despite increased right ventricle stroke volume, the ejection fraction and slope of the end-systolic pressure-volume relationship were significantly reduced in brain-dead donors compared with controls. Diastolic abnormalities were also manifest as increased end-diastolic volume index and prolonged Tau(P< .05). Dopamine improved cardiac output, but without influencing end-systolic pressure-volume relationship, or Tau, and at the expense of further increased right ventricle end-diastolic volume. Before explantation, a significantly higher diastolic volume was also seen in hearts that developed postoperative dysfunction compared with organs without this complication(114.4 vs 77.2 mL/m2, P=.02). Conclusions: Brain death leads to right ventricle dysfunction, which may go undetected with conventional techniques. Right ventricle dilatation could represent an early marker of failure. Refinement of selection criteria to include load-independent indices of performance may be desirable to help expand the donor pool.展开更多
The objective of this paper work is to create a mathematical approach that can quantify the complexity of the General Data Protection Regulation(GDPR)and,at the same time,the implementing of the rules in a company acc...The objective of this paper work is to create a mathematical approach that can quantify the complexity of the General Data Protection Regulation(GDPR)and,at the same time,the implementing of the rules in a company according to the actual benefits of doing so.The scope is to study the rules and regulations imposed by the law,the steps and requirements needed for implementing and to define the indicators that can be used in the mathematical definition of the model.Also,it checks the impact of each indicator in the system and identifies the factors that determine vulnerabilities,what damages are caused by these factors,the risk and impact level of the factors.It proposes a model to evaluate the indicators and the assignment of weights in formula evaluation of each indicator,so the risks of implementing the rules in the business will be smaller as well as the evaluation of the data protection terms of a company will be more balanced and optimal.The approach is from the point of view of the law imposed in implementing the model and the easiness and costs for the companies to do so,including the advantages or disadvantages and the risks they can expose to by doing so.展开更多
基金Supported by CERN and national agencies:CAPES,CNPq,FAPERJ and FINEP(Brazil)NSFC(China)+17 种基金CNRS/IN2P3(France)BMBF,DFG,HGF and MPG(Germany)INFN(Italy)FOM and NWO(The Netherlands)MNi SW and NCN(Poland)MEN/IFA(Romania)Min ES and FANO(Russia)Min ECo(Spain)SNSF and SER(Switzerland)NASU(Ukraine)STFC(United Kingdom)NSF(USA)supported by IN2P3(France),KIT and BMBF(Germany),INFN(Italy),NWOSURF(The Netherlands),PIC(Spain),Grid PP(United Kingdom)support from EPLANET,Marie Sk lodowska-Curie ActionsERC(European Union),Conseil général de Haute-Savoie,Labex ENIGMASS and OCEVU,RégionAuvergne(France),RFBR(Russia),Xunta GalGENCAT(Spain),Royal Society and Royal Commission for the Exhibition of 1851(United Kingdom)
文摘The product of the ∧0/b （-B/0） differential production cross-section and the branching fraction of the decay ∧0/b→ J/ψ pK-（-B/0→ J/ψ-K＊（892）0）is measured as a function of the beauty hadron transverse momentum, PT, and rapidity, y. The kinematic region of the measurements is pT〈20 GeV/c and 2.0 〈g〈4.5.The measurements use a data sample corresponding to an integrated luminosity of 3fb-1 collected by the LHCb detector in pp collisions at centre-of-mass energies √s=7 TeV in 2011 and √s=8 TeV in 2012. Based on previous LHCb results of the fragmentation fraction ratio,f∧0/b/fd,the branching fraction of the decay ∧0/b→ J/ψ pK-is measured to be B（∧0/b→ J/ψ pK-）=（3.17±0.04±0.07±0.34＋0.45/-0.28）×10-4,where the first uncertainty is statistical, the second is systematic, the third is due to the uncertainty on the branching fraction of the decay -B/0 →J/ψ-K＊（892）0,and the fourth is due to the knowledge of f∧0/b/fd.The sum of the asymmetries in the production and decay between ∧0/b and ∧0/bis also measured as a function of PT and y.The previously published branching fraction of ∧0/b→ J/ψ pπ-,relative to that of ∧0/b→ J/ψ pK-,is updated. The branching fractions of ∧0/b→P＋c（→ J/ψp）K-are determined.
文摘AIM To perform a systematic review and meta-analysis on proton pump inhibitors(PPIs) therapy and the risk of Clostridium difficile infection(CDI). METHODS We conducted a systematic search of MEDLINE/Pub Med and seven other databases through January 1990 to March 2017 for published studies that evaluated the association between PPIs and CDI. Adult case-control and cohort studies providing information on the association between PPI therapy and the development of CDI were included. Pooled odds ratios(ORs) estimates with 95% confidence intervals(CIs) were calculated using the random effect. Heterogeneity was assessed by I^2 test and Cochran's Q statistic.Potential publication bias was evaluated via funnel plot, and quality of studies by the Newcastle-Otawa Quality Assessment Scale(NOS). RESULTS Fifty-six studies(40 case-control and 16 cohort) involving 356683 patients met the inclusion criteria and were analyzed. Both the overall pooled estimates and subgroup analyses showed increased risk for CDI despite substantial statistical heterogeneity among studies. Meta-analysis of all studies combined showed a significant association between PPI users and the risk of CDI(pooled OR = 1.99, CI: 1.73-2.30, P < 0.001) as compared with non-users. The association remained significant in subgroup analyses: by design-case-control(OR = 2.00, CI: 1.68-2.38, P < 0.0001), and cohort(OR = 1.98, CI: 1.51-2.59, P < 0.0001); adjusted(OR = 1.95, CI: 1.67-2.27, P < 0.0001) and unadjusted(OR = 2.02, CI: 1.41-2.91, P < 0.0001); unicenter(OR = 2.18, CI: 1.72-2.75, P < 0.0001) and multicenter(OR = 1.82, CI: 1.51-2.19, P < 0.0001); age ≥ 65 years(OR = 1.93, CI: 1.40-2.68, P < 0.0001) and < 65 years(OR = 2.06, CI: 1.11-3.81, P < 0.01). No significant differences were found in subgroup analyses(test for heterogeneity): P = 0.93 for case-control vs cohort, P = 0.85 for adjusted vs unadjusted, P = 0.24 for unicenter vs multicenter, P = 0.86 for age ≥ 65 years and < 65 years. There was significant heterogeneity across studies(I^2 = 85.4%, P < 0.00
文摘Although a considerable number of studies support a substantial increase in incidence, severity, and healthcare costs for Clostridium difficile infection (CDI) in inflammatory bowel disease (IBD), only few evaluate its impact on IBD outcome. Medline and several other electronic databases from January 1993 to October 2013 were searched in order to identify potentially relevant literature. Most of the studies showed that IBD patients with CDI present a greater proportion of worse outcomes than those without CDI. These patients have longer length of hospital stay, higher rates of colectomies, and increased mortality. Patients with ulcerative colitis are more susceptible to CDI and have more severe outcomes than those with Crohn’s disease. However, studies reported variable results in both short- and long-term outcomes. Contrasting results were also found between studies using nationwide data and those reporting from single-center, or between some North-American and European studies. An important limitation of all studies analyzed was their retrospective design. Due to contrasting data often provided by retrospective studies, further prospective multi-center studies are necessary to evaluate CDI impact on IBD outcome. Until then, a rapid diagnosis and adequate therapy of infection are of paramount importance to improve IBD patients’ outcome. The aim of this article is to provide up to date information regarding CDI impact on outcome in IBD patients.
文摘The evolution of the individual in ontogenesis has been studied throughout life and on all sides of development. Studies in the field based on medical rehability performed by a full team such as doctors, physiotherapists and psychologists and not only have shown that the link between the patient’s psychological state and exercise are factors in full dependence and any imbalance can trigger irreparable effects. Psychology is the science that studies the laws of formation, development, functioning and deficiencies related to psychism;it includes a series of fundamental concepts that include: psychic processes, psychic phenomena, psychic attributes, psychic states or psychic activities. Psychic phenomena are the component elements of psychism. In a sense, the psychic phenomena are manifested by external facts, by our behavior, by the motor actions started, by gestures or verbal actions;in the other sense, psychic phenomena are manifested by inner deeds, as the form of ideas, images, feelings, and desires. The motor acts without psychism would be only simple automatisms, without human specifications of adaptation, while the psychism without motor acts would be deprived of the fundamentals of formation and functioning as well as of its production mechanisms. Objective: The objective of this study is to highlight the causal problems of delayed medical recovery in relation to the psychological and emotional factors. This desktop review aims to identify psychoemotional disorders in the case of subjects with operated lumbar disc herniation and aims to adapt a specialized physiotherapeutic protocol by adapting to CIF. The result of this study will be found in the percentage of socio-professional reintegration of the subjects with operated lumbar disc herniation and implicitly the increase in the quality of life. Conclusions: 1) For an effective functional recovery, a psycho-emotional balance is needed;2) A positive attitude actively influences medical rehabilitation;3) Regaining physical, cognitive and social activities
文摘Current researches reveal that the number of cases diagnosed with operated lumbar disc herniation is growing rapidly, which should draw an increased attention to the treatment used. The objective of this study is to perform a comparative analysis between the application of a classical physical-kinetic program and the application of a combined kinetic program. This research will be conducted on 20 subjects with ages, between 40 - 50 years old, in INEMRCM Bucharest, for 14 days - 1 hour a day. Each subject underwent an invasive surgery for lumbar disc herniation on the L5-S1 vertebrae. During the research, the 2 patients will be given a physical-kinetic program, adapted to the pathology of the operated lumbar disc herniation. The purpose of this research is to check the efficiency of each kinetic program. Furthermore, through the muscular and articular evaluation made in the initial phase and the final phase, it will be possible to discuss the comparative evolution of the established kinetic program and the functional gain obtained. In conclusion, the research shows that mechanized therapy results in faster functional rehabilitation and physical exercise substantially improves quality of life.
文摘Background and Aims: Several studies have shown that hypoglycaemia, especially a severe episode is associated with an increased mortality rate in diabetes mellitus subjects with previous cardiovascular disease or acute coronary syndrome. One of the presumed mechanisms is the proarrhythmic effect of hypoglycaemia related to the prolongation of the action potential, or the catecholamine surge that follows an episode. The aim of this case series analysis was to investigate the relationship between hypoglycaemia and glucose variability with arrhythmic events in type 2 diabetes patients who suffered an acute myocardial infarction. Materials and Methods: We selected patients admitted consecutively to the cardiology department of Clinical Emergency Hospital in Bucharest for a period of three months with acute myocardial infarction and previously diagnosed type 2 diabetes. For each patient, a retrospective continuous glucose monitoring system (CGMS) or glucose sensor (Medtronic<sup>®</sup> Enlite, USA) and a dual electrocardiograph and blood pressure monitor for 24 hours were available. Also, patients had an oscillometric device (Arteriograph<sup>®</sup> TensioMed Ltd) for 24 hours or non-invasive monitoring of central blood pressure, pulse wave velocity and augmentation index. The data were analysed using Medtech<sup>®</sup>, TensioWin<sup>®</sup> and Carelink iPro<sup>®</sup> softwares. We used SPSS<sup>®</sup> version 20.0 (IBM) for the statistical analysis. The results are presented as median and interquartile range (IQR). Results and Discussion: Ten type 2 diabetes patients (4 males, 6 females) with anterior (4/10) and inferior acute myocardial infarction (6/10) were included. They were treated with insulin (3/10), sulphonylurea (Gliclazide) plus Metformin (4/10), Metformin monotherapy (2/10), or all three (1/10). The patients had a median age of 67.5 (3.25) years with a median disease duration of 8 (7.75) years. The median body mass index was 29.54 (5.65) kg/m<sup>2</sup>. The median HbA1c w
文摘A series of events relating to inferior medical devices has brought about changes in the legal requirements regarding quality control on the part of regulators. Apart from clinical studies, register and routine data will play an essential role in this context. To ensure adequate use of these data, adapted methodologies are required as register data in fact represent a new scientific entity. For the interpretation of register and routine data several limitations of published data should be taken into account. In many cases essential parameters of study cohorts- such as age, comorbidities, the patients' risk profiles or the hospital profile- are not presented. Required data and evaluation procedures differ significantly, for example, between hip and spine implants. A "one fits for all" methodology is quite unlikely to exist and vigorous efforts will be required to develop suitable standards in the next future. The new legislation will affect all high-risk products, besides joint implants also contact lenses, cardiac pacemakers or stents, for example, the new regulations can markedly enhance product quality monitoring. Register data and clinical studies should not be considered as competitors, they complement each other when used responsibly. In the future follow-up studies should increasingly focus on specific questions, while global follow-up investigations regarding product complication rates and surgical methods will increasingly be covered by registers.
文摘Background After minimally invasive repair for pectus excavatum (MIRPE), similar procedures for pectus carinatum were developed. This study aimed to analyse the various published techniques of minimal access repair for pectus carinatum (MARPC) and compare the outcomes. Data sources Literature was reviewed on PubMed with the terms 'pectus carinatum', 'minimal access repair', 'thoracos-copy' and 'children'. Results Twelve MARPC techniques that included 13 articles and 140 patients with mean age 15.46 years met the inclusion criteria. Success rate of corrections wasn = 125, about 89% in cumulative reports, with seven articles reporting 100%. The complication rate was 39.28%. Since the pectus bar is placed over the sternum and has a large contact area, skin irritation was the most frequent morbidity (n = 20, 14.28%). However, within the complication group (n = 55), wire breakage (n = 21, 38.18%) and bar displacement (n = 10, 18.18%) were the most frequent complications. Twenty-two (15.71%) patients required a second procedure. Recurrences have been reported in four of twelve techniques. There were no lethal outcomes. Conclusions MARPC techniques are not standardized, as MIRPE are, so comparative analysis is difficult as the only common denominator is minimal access. Surgical morbidity is high in MARPC and affects > 2/3rd patients with about 15% requiring surgery for complication management.
基金The study was approved by the Ethics Board of the Westphalian Wilhelms-University of Muenster and Medical Council of Westphalia-Lippe,Germany,No.2017-490-f-S.
文摘BACKGROUND Patients with primary sclerosing cholangitis(PSC)are at a high risk of developing cholestatic liver disease and biliary cancer,and endoscopy is crucial for the complex management of these patients.AIM To clarify the utility of recently introduced digital single-operator video cholangioscopy(SOVC)for the endoscopic management of PSC patients.METHODS In this observational study,all patients with a history of PSC and in whom digital SOVC(using the SpyGlass DS System)was performed between 2015 and 2019 were included and retrospectively analysed.Examinations were performed at a tertiary referral centre in Germany.In total,46 SOVCs performed in 38 patients with a history of PSC were identified.The primary endpoint was the evaluation of dominant biliary strictures using digital SOVC,and the secondary endpoints were the performance of selective guidewire passage across biliary strictures and the diagnosis and treatment of biliary stone disease in PSC patients.RESULTS The 22 of 38 patients had a dominant biliary stricture(57.9%).In 4 of these 22 patients,a cholangiocellular carcinoma was diagnosed within the stricture(18.2%).Diagnostic evaluation of dominant biliary strictures using optical signs showed a sensitivity of 75%and a specificity of 94.4%to detect malignant strictures,whereas SOVC-guided biopsies to gain tissue for histopathological analysis showed a sensitivity of 50%and a specificity of 100%.In 13%of examinations,SOVC was helpful for guidewire passage across biliary strictures that could not be passed by conventional methods(technical success rate 100%).Biliary stone disease was observed in 17.4%of examinations;of these,in 37.5%of examinations,biliary stones could only be visualized by SOVC and not by standard fluoroscopy.Biliary stone treatment was successful in all cases(100%);25%required SOVC-assisted electrohydraulic lithotripsy.Complications,such as postinterventional cholangitis and pancreatitis,occurred in 13%of examinations;however,no procedure-associated mortality occurred.CONCLUSION Digit
基金the Department of the Army(Cooperative Agreement Number:DAMD17-97-2-7016)the National Institutes of Health(R01 CA092415)。
文摘We report on the use of a fiber-based Mueller-matrix optical coherence tomography(OCT)system with continuous source-polarization modulation for in vivo imaging of early stages of skin cancer in SENCAR mice.A homemade hand-held probe with integrated optical scanning and beam delivering optics was coupled in the sample arm.The OCT images show the morphological changes in skin resulting from pre-cancerous papilloma formations that are consistent with histology,thus demonstrating the system’s potential for early skin cancer detection.
文摘This article aims to study the indicators used in the financial analysis for credit and explain them. Also it checks the impact of each indicator in credit analysis and what happens if the pointer is changed deliberately to get the loan, giving some possible ways to do it and analyzing them. It proposes a new model to evaluate the indicators and the assignment of weights in formula evaluation of each indicator, so the risks of granting credit will be smaller as well as the evaluation of the financial terms of a company will be more balanced and optimal. The scope is to equilibrate the weights of each indicator in the fmancial credit analyze not by rescoring its value but by assigning shares in the evaluation formula. Doing this, it can be considered as a double checking using the same parameters and it lowers the risks in the money recovering. As it is debated in the article anyone can do fxaud to obtain a loan by altering the documents they provide through which some can do it good and even get uncaught. The scope is not to find what they did; it is to get protected even if they do it.
文摘Einstein＇s equation,in its standard form,breaks down at the Big Bang singularity.A new version,equivalent to Einstein＇s whenever the latter is defined,but applicable in wider situations,is proposed.The new equation remains smooth at the Big Bang singularity of the Friedmann-Lemaatre-Robertson-Walker model.It is a tensor equation defined in terms of the Ricci part of the Riemann curvature.It is obtained by taking the Kulkarni-Nomizu product between Einstein＇s equation and the metric tensor.
文摘We solve two Markowitz optimization problems for the one-step financial model with a finite number of assets. In our results, the classical (inefficient) constraints are replaced by coherent measures of risk that are continuous from below. The methodology of proof requires optimization techniques based on functional analysis methods. We solve explicitly both problems in the important case of Tail Value at Risk.
文摘Removal of foreign bodies from seed mixtures, or their calibration for use as planting material, as well as fraction classification of granular materials requires screening surfaces with vibratory motion. This paper presents some aspects on the working process of a sieve, made of perforated sheet and having an outer conical surface with oscillatory circular motion （alternative） on the horizontal. Results are presented for some experimental researches on the movement of material on the sieve, for various kinematical parameters of the sieve （amplitude and oscillation frequency）. A conical sieve, suspended at the upper and lower in three points, was tested for screening of rapeseeds in order to estimate the influence of oscillation frequency on the screening process. Curves were drawn for separation intensity on the sieve generating line, and by regression analysis with normal distribution law were determined the equation coefficients and the correlation with experimental data. Movement of material on the sieve and its working process, in general, was appreciated by means of the peak position of distribution curve depending on the oscillation frequency of the sieve, considering that the normal distribution law correlates very well the data obtained by experiments.
基金Acknowledgments This work has benefited from the use of 1） Los Alamos Neutron Science Facility at Los Alamos National Laboratory and 2） ISIS Pulsed Neutron and Muon Source at Rutherford-Appleton Laboratory. The financial support of the National Science Foundation＇s 1） International Materials Institutes （IMI） under DMR-0231320, 2） Integrative Graduate Education and Research Training （IGERT） under DGE-9987548, 3） Combined Research and Curriculum Development （CRCD） under EEC-9527527 and EEC-0203415, and 4） Major Research Instrumentation （MRI） under DMR-0231320 at the University of Tennessee with Dr HUBER C, Dr Van HARTESVELDT C J, Dr DUTTA D, Dr JENNINGS W, Dr G0LDBERG L, Ms P0ATS M, and Dr B0ULDIN C R as the Program Directors, is greatly appreciated. Additional funding for this project was gratefully received from the Tennessee Advanced Materials Laboratory, with Prof. PLUMMER E W as the Director.
文摘Study of neutrino properties is nowadays one of the most active domains of research in physics. On the one hand, fundamental properties of the neutrinos like their absolute mass, their character (are they Dirac or Majorana particles?) and the number of neutrino flavors, are still unknown. On the other hand, the knowledge of these properties are of great importance since the neutrinos are very abundant in nature and play a key role in nuclear and particle physics, astrophysics and cosmology. In addition, the results of the neutrino oscillation experiments have convincingly showed that neutrinos have mass and mix, in contradiction to the initial assumptions of the Standard Model. In this context there is an increased interest in the study of the Lepton Number Violating (LNV) processes, since they are capable to decide on the above mentioned neutrino properties. Since recently, the neutrinoless double beta (0nββ) decay was considered the only process able to distinguish between Dirac or Majorana neutrinos and to give a hint on the absolute mass of the electron neutrino. At present, the increased luminosity of the LHC experiments at CERN makes it feasable the search for LNV processes at LHC as well. Besides the neutrino character, these studies can also shed light on the existence of other types of neutrinos (the sterile neutrinos), than the three known ones. In this paper, I make a brief review on our present knowledge about the neutrino properties and on the way they can be probed by LNV processes at low- and high-energies. Particularly, I refer to the 0nββ decay process and to the first attempts of searching of LNV processes in hadron collider experiments, particularly in LHC experiments at CERN-Geneva.
文摘Objectives: Experimental and clinical data suggest that brain death predominantly affects the right ventricle. We aimed to investigate right ventricle function after brain death and during clinical transplantation with load-independent methods. Methods: Patients with and without brain death were enrolled. A total of 33 consecutive heart donors(5 live, “domino”donors)and 10 patients undergoing coronary surgery(coronary artery bypass graft controls) were studied with pressure-volume loops in the right ventricle. Contractile reserve was measured with dopamine stimulation. Results: Brain-dead donors had a higher mean cardiac index than coronary artery bypass graft controls(3.3 vs 2.8 L/min/m2), but impaired load-independent indices. Despite increased right ventricle stroke volume, the ejection fraction and slope of the end-systolic pressure-volume relationship were significantly reduced in brain-dead donors compared with controls. Diastolic abnormalities were also manifest as increased end-diastolic volume index and prolonged Tau(P< .05). Dopamine improved cardiac output, but without influencing end-systolic pressure-volume relationship, or Tau, and at the expense of further increased right ventricle end-diastolic volume. Before explantation, a significantly higher diastolic volume was also seen in hearts that developed postoperative dysfunction compared with organs without this complication(114.4 vs 77.2 mL/m2, P=.02). Conclusions: Brain death leads to right ventricle dysfunction, which may go undetected with conventional techniques. Right ventricle dilatation could represent an early marker of failure. Refinement of selection criteria to include load-independent indices of performance may be desirable to help expand the donor pool.
基金Human Capital Operational Program 2014-2020,project number POCU/380/6/13/125245 No.36482/23.05.2019“Excellence in interdisciplinary Ph.D.and post-Ph.D.research,career alternatives through entrepreneurial initiative(EXCIA)”,coordinator The Bucharest University of Economic Studies.
文摘The objective of this paper work is to create a mathematical approach that can quantify the complexity of the General Data Protection Regulation(GDPR)and,at the same time,the implementing of the rules in a company according to the actual benefits of doing so.The scope is to study the rules and regulations imposed by the law,the steps and requirements needed for implementing and to define the indicators that can be used in the mathematical definition of the model.Also,it checks the impact of each indicator in the system and identifies the factors that determine vulnerabilities,what damages are caused by these factors,the risk and impact level of the factors.It proposes a model to evaluate the indicators and the assignment of weights in formula evaluation of each indicator,so the risks of implementing the rules in the business will be smaller as well as the evaluation of the data protection terms of a company will be more balanced and optimal.The approach is from the point of view of the law imposed in implementing the model and the easiness and costs for the companies to do so,including the advantages or disadvantages and the risks they can expose to by doing so.
