AIM:To explore whether preoperative chemoradiation therapy improves survival of patients with pancreatic cancer undergoing resectional surgery. METHODS:Forty-seven patients with a malignant pancreatic tumor localized ...AIM:To explore whether preoperative chemoradiation therapy improves survival of patients with pancreatic cancer undergoing resectional surgery. METHODS:Forty-seven patients with a malignant pancreatic tumor localized in the head or uncinate process of the pancreas underwent radical pancreaticoduodenectomy. Twenty-two received chemoradiation therapy (gemcitabine and radiation dose 50.4 Gy) before surgery (CRR) and 25 patients underwent surgery only (RO). The study was non-randomised. Patients were identified from a prospective database. RESULTS:The median survival time was 30.2 mo in the CRR group and 35.9 mo in the RO group. No statistically significant differences were found in subclasses according to lymph node involvement,TNM stages,tumor size,or perineural invasion. The one,three and five year survival rates were 81%,33% and 33%,respectively,in the CRR group and 72%,47% and 23%,respectively,in the RO group. In ductal adenocarcinoma,the median survival time was 27 mo in the CRR group and 20 mo in the RO group. No statistically significant differences were found in the above subclasses. The one,three and five year survival rates were 79%,21% and 21%,respectively,in the CRR group and 64%,50% and 14%,respectively,in the RO group. The overall hospital mortality rate was 2%. The morbidity rate was 45% in the CRR group and 32% (NS) in the RO group. CONCLUSION:Major multicenter randomized studies are needed to conclusively assess the impact of neoadjuvant treatment in the management of pancreatic cancer.展开更多
Background:The presence of a single umbilical artery(SUA)is a fetal soft marker of congenital abnormalities.Among the most common related malformations,there are cardiological,nephrourological and digestive anomalies,...Background:The presence of a single umbilical artery(SUA)is a fetal soft marker of congenital abnormalities.Among the most common related malformations,there are cardiological,nephrourological and digestive anomalies,most of which are considered to have a vascular etiology.There is an association between increased incidence of intrauterine growth retardation and adverse perinatal indicators,but whether this association is due to related anomalies or isolated SUA(SUA)is controvisal.Methods:We reviewed 96 cases of iSUA and non-isolated SUA(niSUA),diagnosed in a period of two years in a referral hospital for high-risk pregnancies.Data on prenatal explorations,including fetal ultrasonography and karyotyping,were obtained.niSUA was diagnosed when no malformations were found prenatally or in postnatal evaluation.Results:Sixty-six newborns(68.8%)had no other anomalies and 30(31.3%)presented with a variety of malformations including heart diseases,urophaties,digestive,nervous and musculoskeletal disorders,genetic abnormalities and complex malformations.Cardiological and nephrourological abnormalities were found to be the most frequent association with a SUA(both in 23.8%of malformed SUA newborns).Intrauterine growth restriction was not higher in iSUA newborns than in a normal population.Utrasound allowed optimal prenatal diagnosis in most cases.Conclusions:The prognosis of the fetus with a SUA is determined by the presence of other malformations observed by an expert sonographer.If no other findings are made,only a routine physical examination should be performed in newborns,but no other complementary examinations are required.展开更多
Purpose: The Harmonic Neutron Hypothesis, HNH, has demonstrated that many of the fundamental physical constants, including the quarks, are associated with partial harmonic fractional exponents, , of a fundamental freq...Purpose: The Harmonic Neutron Hypothesis, HNH, has demonstrated that many of the fundamental physical constants, including the quarks, are associated with partial harmonic fractional exponents, , of a fundamental frequency, v<sub>F</sub>. The model has shown that the properties of the quarks are based on a progression of prime number composites. They also fall on three separate power law lines related to integer factors of the Y-intercept, , of a fundamental electromagnetic line which is scaled by the Rydberg constant, R and Planck’s constant. The quark lines are scaled by the quantum number factors {1, 2, 3}, and their Y-intercepts are referred to as n<sub>bem</sub>. The goal is to present a new proto-quark model in a six-quark inverted triangular array that defines the global organization of the valence quarks, which determines the hadronic quantum numbers, the standard hadron quark model, and the Cabibbo-Kobayashi-Maskawa (CKM) matrix. Methods: The charm, bottom, top quarks are associated with power law line Y-intercept, n<sub>bem</sub> equal to 1;the strange and down quarks with n<sub>bem</sub> equal to 2;and the up quark with n<sub>bem</sub> equal to 3. An inverted equilateral triangular array with three rows arranged from upper row (triangle base) to bottom row (triangle vertex), is associated respectively with n<sub>bem</sub> numbers 1, 2, and 3. The novelty of our perspective thus defines a new global valence quark organization which supersedes the Standard hadron composite quark model. The quarks are ordered via relative mass, partial fractions, and n<sub>bem</sub> quantum number. The top row of our inverted triangle includes the c, b, and t quarks from left to right;the middle row depicts the d and s quarks;and the bottom row, the up quark. Results: Our array depicts a quantum generator of the global organization of the valence quarks defining the composite quark model. The vertices of the triangular array are the up quarks, the midpoints are the down quarks. All weak transitions are from a corner to 展开更多
Fetal growth restriction(FGR),or intrauterine growth restriction(IUGR),is a complication of pregnancy where the fetus does not achieve its genetic growth potential.FGR is characterized by a pathological retardation of...Fetal growth restriction(FGR),or intrauterine growth restriction(IUGR),is a complication of pregnancy where the fetus does not achieve its genetic growth potential.FGR is characterized by a pathological retardation of intrauterine growth velocity in the curve of intrauterine growth.However,the FGR definition is still debated,and there is a lack of a uniform definition in the literature.True IUGR,compared to constitutional smallness,is a pathological condition in which the placenta fails to deliver an adequate supply of oxygen and nutrients to the developing fetus.Infants with IUGR,compared to appropriately grown gestational age infants,have a significantly higher risk of mortality and neonatal complications with long-term consequences.Several studies have demonstrated how suboptimal fetal growth leads to long-lasting physiological alterations for the developing fetus as well as for the newborn and adult in the future.The long-term effects of fetal growth retardation may be adaptations to poor oxygen and nutrient supply that are effective in the fetal period but deleterious in the long term through structural or functional alterations.Epidemiologic studies showed that FGR could be a contributing factor for adult chronic diseases including cardiovascular disease,metabolic syndrome,diabetes,respiratory diseases and impaired lung function,and chronic kidney disease.In this review we discussed pathophysiologic mechanisms of FGR-related complications and potential preventive measures for FGR.展开更多
Purpose: To accurately derive H0 from subatomic constants in abscence of any standard astronomy data. Methods: Recent astronomical data have determined a value of Hubble’s constant to range from 76.9+3.9-3.4+10.0-8.0...Purpose: To accurately derive H0 from subatomic constants in abscence of any standard astronomy data. Methods: Recent astronomical data have determined a value of Hubble’s constant to range from 76.9+3.9-3.4+10.0-8.0 to 67.80 ± 0.77 (km/s)/Mpc. An innovative prediction of H0 is obtained from harmonic properties of the frequency equivalents of neutron, n0, in conjunction with the electron, e;the Bohr radius, α0;and the Rydberg constant, R. These represent integer natural unit sets. The neutron is converted from its frequency equivalent to a dimensionless constant,, where “h” = Planck’s constant, and “s” is measured in seconds. The fundamental frequency, Vf, is the first integer series set . All other atomic data are scaled to Vf as elements in a large, but a countable point set. The present value of H0 is derived and ΩM assumed to be 0. An accurate derivation of H0 is made using a unified power law. The integer set of the first twelve integers N12 {1,2,…,11,12}, and their harmonic fractions exponents of Vf represent the first generation of bosons and particles. Thepartial harmonic fraction, -3/4, is exponent of Vf which represents H0. The partial fraction 3/4 is associated with a component of neutron beta decay kinetic energy. Results: H0 is predicted utilizing a previously published line used to derive Planck time, tp. The power law line of the experimental H0 and tp conforms to the predicted line. Conclusions: H0 can be predicted from subatomic data related to the neutron and hydrogen.展开更多
Extreme preterm infants(<28 weeks'gestation)often require positive pressure ventilation with oxygen during postnatal stabilization in the delivery room.To date,optimal inspired fraction of oxygen(FiO_(2))still ...Extreme preterm infants(<28 weeks'gestation)often require positive pressure ventilation with oxygen during postnatal stabilization in the delivery room.To date,optimal inspired fraction of oxygen(FiO_(2))still represents a conundrum in newborn care oscillating between higher(>60%)and lower(<30%)initial FiO_(2).Recent evidence and meta-analyses have underscored the predictive value for survival and/or relevant clinical outcomes of the Apgar score and the achievement of arterial oxygen saturation measured by pulse oximetry≥85%at 5 minutes after birth.New clinical trials comparing higher versus lower initial FiO_(2)have been launched aiming to optimize postnatal stabilization of extreme preterm while avoiding adverse effects of hypoxemia or hyperoxemia.展开更多
The Harmonic Neutron Hypothesis, HNH, has demonstrated that many of the fundamental physical constants including particles and bosons are associated with specific quantum integers, n. These integers define partial har...The Harmonic Neutron Hypothesis, HNH, has demonstrated that many of the fundamental physical constants including particles and bosons are associated with specific quantum integers, n. These integers define partial harmonic fractional exponents, 1 ± (1/n), of a fundamental frequency, Vf. The goal is to evaluate the prime and composite factors associated with the neutron n0, the quarks, the kinetic energy of neutron beta decay, the Rydberg constant, R, e, a0, H0, h, α, W, Z, the muon, and the neutron gluon. Their pure number characteristics correspond and explain the hierarchy of the particles and bosons. The elements and black body radiation represent consecutive integer series. The relative scale of the constants cluster in a partial harmonic fraction pattern around the neutron. The global numerical organization is related to the only possible prime factor partial fractions of 2/3, or 3/2, as pairs of 3 physical entities with a total of 6 in each group. Many other progressively resonant prime number factor patterns are identified with increasing numbers of smaller factors, higher primes, or larger partial fractions associated with higher order particles or bosons.展开更多
The Harmonic Neutron Hypothesis, HNH, has demonstrated that many of the fundamental physical constants are associated with quantum integers, n, within a classic integer and partial harmonic fraction system, and follow...The Harmonic Neutron Hypothesis, HNH, has demonstrated that many of the fundamental physical constants are associated with quantum integers, n, within a classic integer and partial harmonic fraction system, and follow a known two-dimensional, 2D, power law geometry. These are exponents of a fundamental frequency, vF, the basis of which is the annhilation frequency of the neutron, vn0. Our goal to a first approximation is to derive the frequency equivalents of the Rydberg constant, vR, the Bohr radius, va0, the electron, ve-, and the reciprocal fine structure constant, 1/α all from vn0, π, and a small set of prime integers only. The primes used in the derivations are respectively 2, 3, 5, 7, and 11. This is possible since it is known that the number 3 is associated with R, 5 with a0, 7 with e-, and 11 with 1/α. In addition, the interrelationships of the frequency ratio equivalents of these natural units with 2 and π are known, thus allowing for the derivation of any one from the others. Also the integer and partial fractions of a0, e-, and n0 define Planck time squared, tP2. An accurate estimate of tP2 from vF alone is also related to the integer 2 since gravity is a kinetic force. Planck time squared, tP2 scales the Y-axis, and vF scales the X-axis. In conclusion the quantum properties of hydrogen are derived from only the natural unit physical data of the neutron, to a relative precision ranging from 2.6 × 10-3 to 6.7 × 10-4. This supports the hypothesis that many of the fundamental constants are related to vn0.展开更多
A number of solid tumors contain a distinct subpopulation of cells, termed cancer stem cells (CSCs) which represent the source for tissue renewal and hold malignant potential and which would be responsible for therapy...A number of solid tumors contain a distinct subpopulation of cells, termed cancer stem cells (CSCs) which represent the source for tissue renewal and hold malignant potential and which would be responsible for therapy resistance. Today, the winning goal in cancer research would be to find drugs to kill both cancer cells and cancer stem cells, while sparing normal cells. Osteosarcoma is an aggressive pediatric tumor of growing bones that, despite surgery and chemotherapy, is prone to relapse. We have recently selected from human osteosarcoma MG63 cells a cancer stem-like cell line (3AB-OS), which has unlimited proliferative potential, high levels of stemness-related markers, and in vivo tumorforming capacity in xenograft assays. Here, we have shown that 3AB-OS cells can differentiate in vitro into endoderm-, mesoderm-and ectoderm-derived lineages. Cell differentiation is morphological, molecular and functional. We propose that this model system of 3AB-OS differentiation in vitro might have a number of useful purposes, among which the study of molecular mechanisms of osteosarcoma origin, and the analysis of factors involved in specification of the various cell lineages. We still do not know either what are the shared and distinguishing characters between CSCs and normal stem cells, or what is the reason why the cancer stem cells, like the normal stem cells, have the ability to differentiate toward the derivatives of the primary germ layers. It is possible that each of the differentiation capability may be exploited by CSCs to supply their needs of growing and surviving in hostile microenvironment.展开更多
Two main issues are crucial for neonatology at present： first, the increased rate of preterm delivery （〉 10%） especially in low and middle income countries or even in industrialized countries lacking a universal a...Two main issues are crucial for neonatology at present： first, the increased rate of preterm delivery （〉 10%） especially in low and middle income countries or even in industrialized countries lacking a universal access to health care;展开更多
We find that π represents dual attributes. One is within the purely mathematical domain and can be derived for example, from infinite series, among several other methods. The other is within a 2D geometric-physical d...We find that π represents dual attributes. One is within the purely mathematical domain and can be derived for example, from infinite series, among several other methods. The other is within a 2D geometric-physical domain. This paper analyzes several physical constants from an analogous perspective where they are defined solely by mathematical and 2D geometric properties independent of any actual physical scaling data. The constants are evaluated as natural unit frequency equivalents of the neutron, electron, Bohr radius, Rydberg constant, Planck’s constant, Planck time, a Black hole with a Schwarzschild radius, the distance light travels in one time unit;and the fine structure constant. These constants are defined within two inter-related harmonic domains. In the linear domain, the ratios of the frequency equivalents of the Rydberg constant, Bohr radius, electron;and the fine structure constant are related to products of 2 and π. In the power law domain, their partial harmonic fraction powers, and the integer fraction powers of the fundamental frequency for Planck time are known. All of the constants are then derived at the point where a single fundamental frequency simultaneously fulfills both domains independent of any direct physical scale data. The derived values relative errors from the known values range from 10-3 to 10-1 supporting the concept and method.展开更多
Contralateral axillary metastasis (CAM) is a rare entity normally treated as a systemic disease. Recent publications have proposed aggressive surgical treatment with benefits to the patients in terms of survival. We p...Contralateral axillary metastasis (CAM) is a rare entity normally treated as a systemic disease. Recent publications have proposed aggressive surgical treatment with benefits to the patients in terms of survival. We present a case of a 74-year-old patient with a history of unilateral breast cancer, recurrence on the ipsilateral breast and then development of a CAM. The patient was treated with aggressive surgical treatment, but she developed an early recurrence of the disease with distant metastasis. There is limited evidence of the correct management of CAM, although proposed to treat it as a loco regional disease, individualized and multidisciplinary management is the best option for these patients.展开更多
We report a case of a 40</span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;">year-old woman, second pregnancy, previous cesarean section due ...We report a case of a 40</span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;">year-old woman, second pregnancy, previous cesarean section due to intrauterine growth restriction and placenta accreta spectrum disorders. She was 25 weeks gestational age, admitted to the hospital 25 weeks gestational age, diagnosed with fetal death. Initial conservative management attempt with uterine preservation progresses to complications requiring total hysterectomy followed by a rare outcome: pelvic thrombi with uterine necrosis, with its associated clinical complications.展开更多
<strong>Introduction:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Prematurity is a public health problem in Brazil, ...<strong>Introduction:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Prematurity is a public health problem in Brazil, with 12% of deliveries occurring before 37 weeks of gestation. The measurement of the cervix in the second trimester is already established as a method of screening for prematurity and some studies point out advantages to start this screening in the first trimester. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> To define the correlation between the length of the endocervix by transvaginal ultrasound in the first trimester (11 to 14 weeks) with spontaneous early deliveries. </span><b><span style="font-family:Verdana;">Method:</span></b><span style="font-family:Verdana;"> A prospective and observational study realized in a suplementar and private ultrasound clinic and hospital of Porto Alegre, Brazil between 2019-2020. Ultrasound screening of cervix was performed in singleton pregnancies in first and second trimester of pregnancy and correlated with age of delivery. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> 142 pregnant women were studied, 80% were in the first pregnancy. The average age was 33.8 years. The rate of prematurity was 18% before 37 weeks and 4% before 34 weeks. The average of cervix measured in the first and second trimesters in deliveries before 34 weeks was 32.7 mm and 29.3 mm, respectively. In term deliveries the median cervical length was 38.8 mm and 37.8 mm, respectively. When analyzing the measurements of the cervix in the second trimester, the cervix was smaller (p = 0.008) among deliveries below 34 weeks (29</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">mm) than deliveries after 37 weeks. No statistically related differences were found between preterm birth and first trimester cervix measurements. </span><b><span 展开更多
Severe acute respiratory syndrome coronavirus 2(SARSCoV-2)is a novel beta coronavirus that causes coronavirus disease 2019(COVID-19),a severe infectious respiratory disease.In January 2020,the World Health Organizatio...Severe acute respiratory syndrome coronavirus 2(SARSCoV-2)is a novel beta coronavirus that causes coronavirus disease 2019(COVID-19),a severe infectious respiratory disease.In January 2020,the World Health Organization(WHO)declared the outbreak a public health emergency of international concern,and in March 2020.展开更多
BACKGROUND The coronavirus disease 2019(COVID-19) pandemic produced changes in intensive care units(ICUs) in patient care and health organizations. The pandemic event increased patients’ risk of developing psychologi...BACKGROUND The coronavirus disease 2019(COVID-19) pandemic produced changes in intensive care units(ICUs) in patient care and health organizations. The pandemic event increased patients’ risk of developing psychological symptoms during and after hospitalisation. These consequences also affected those family members who could not access the hospital. In addition, the initial lack of knowledge about the virus and its management, the climate of fear and uncertainty, the increased workload and the risk of becoming infected and being contagious, had a strong impact on healthcare staff and organizations. This highlighted the importance of interventions aimed at providing psychological support to ICUs, involving patients, their relatives, and the staff;this might involve the reorganisation of the daily routine and rearrangement of ICU staff duties.AIM To conduct a systematic review of psychological issues in ICUs during the COVID-19 pandemic involving patients, their relatives, and ICU staff.METHODS We investigated the PubMed and the ClinicalTrials.gov databases and found 65 eligible articles,upon which we commented.RESULTS Our results point to increased perceived stress and psychological distress in staff, patients and their relatives and increased worry for being infected with severe acute respiratory syndrome coronavirus-2 in patients and relatives. Furthermore, promising results were obtained for some psychological programmes aiming at improving psychological measures in all ICU categories.CONCLUSION As the pandemic limited direct inter-individual interactions, the role of interventions using digital tools and virtual reality is becoming increasingly important. All considered, our results indicate an essential role for psychologists in ICUs.展开更多
文摘AIM:To explore whether preoperative chemoradiation therapy improves survival of patients with pancreatic cancer undergoing resectional surgery. METHODS:Forty-seven patients with a malignant pancreatic tumor localized in the head or uncinate process of the pancreas underwent radical pancreaticoduodenectomy. Twenty-two received chemoradiation therapy (gemcitabine and radiation dose 50.4 Gy) before surgery (CRR) and 25 patients underwent surgery only (RO). The study was non-randomised. Patients were identified from a prospective database. RESULTS:The median survival time was 30.2 mo in the CRR group and 35.9 mo in the RO group. No statistically significant differences were found in subclasses according to lymph node involvement,TNM stages,tumor size,or perineural invasion. The one,three and five year survival rates were 81%,33% and 33%,respectively,in the CRR group and 72%,47% and 23%,respectively,in the RO group. In ductal adenocarcinoma,the median survival time was 27 mo in the CRR group and 20 mo in the RO group. No statistically significant differences were found in the above subclasses. The one,three and five year survival rates were 79%,21% and 21%,respectively,in the CRR group and 64%,50% and 14%,respectively,in the RO group. The overall hospital mortality rate was 2%. The morbidity rate was 45% in the CRR group and 32% (NS) in the RO group. CONCLUSION:Major multicenter randomized studies are needed to conclusively assess the impact of neoadjuvant treatment in the management of pancreatic cancer.
文摘Background:The presence of a single umbilical artery(SUA)is a fetal soft marker of congenital abnormalities.Among the most common related malformations,there are cardiological,nephrourological and digestive anomalies,most of which are considered to have a vascular etiology.There is an association between increased incidence of intrauterine growth retardation and adverse perinatal indicators,but whether this association is due to related anomalies or isolated SUA(SUA)is controvisal.Methods:We reviewed 96 cases of iSUA and non-isolated SUA(niSUA),diagnosed in a period of two years in a referral hospital for high-risk pregnancies.Data on prenatal explorations,including fetal ultrasonography and karyotyping,were obtained.niSUA was diagnosed when no malformations were found prenatally or in postnatal evaluation.Results:Sixty-six newborns(68.8%)had no other anomalies and 30(31.3%)presented with a variety of malformations including heart diseases,urophaties,digestive,nervous and musculoskeletal disorders,genetic abnormalities and complex malformations.Cardiological and nephrourological abnormalities were found to be the most frequent association with a SUA(both in 23.8%of malformed SUA newborns).Intrauterine growth restriction was not higher in iSUA newborns than in a normal population.Utrasound allowed optimal prenatal diagnosis in most cases.Conclusions:The prognosis of the fetus with a SUA is determined by the presence of other malformations observed by an expert sonographer.If no other findings are made,only a routine physical examination should be performed in newborns,but no other complementary examinations are required.
文摘Purpose: The Harmonic Neutron Hypothesis, HNH, has demonstrated that many of the fundamental physical constants, including the quarks, are associated with partial harmonic fractional exponents, , of a fundamental frequency, v<sub>F</sub>. The model has shown that the properties of the quarks are based on a progression of prime number composites. They also fall on three separate power law lines related to integer factors of the Y-intercept, , of a fundamental electromagnetic line which is scaled by the Rydberg constant, R and Planck’s constant. The quark lines are scaled by the quantum number factors {1, 2, 3}, and their Y-intercepts are referred to as n<sub>bem</sub>. The goal is to present a new proto-quark model in a six-quark inverted triangular array that defines the global organization of the valence quarks, which determines the hadronic quantum numbers, the standard hadron quark model, and the Cabibbo-Kobayashi-Maskawa (CKM) matrix. Methods: The charm, bottom, top quarks are associated with power law line Y-intercept, n<sub>bem</sub> equal to 1;the strange and down quarks with n<sub>bem</sub> equal to 2;and the up quark with n<sub>bem</sub> equal to 3. An inverted equilateral triangular array with three rows arranged from upper row (triangle base) to bottom row (triangle vertex), is associated respectively with n<sub>bem</sub> numbers 1, 2, and 3. The novelty of our perspective thus defines a new global valence quark organization which supersedes the Standard hadron composite quark model. The quarks are ordered via relative mass, partial fractions, and n<sub>bem</sub> quantum number. The top row of our inverted triangle includes the c, b, and t quarks from left to right;the middle row depicts the d and s quarks;and the bottom row, the up quark. Results: Our array depicts a quantum generator of the global organization of the valence quarks defining the composite quark model. The vertices of the triangular array are the up quarks, the midpoints are the down quarks. All weak transitions are from a corner to
文摘Fetal growth restriction(FGR),or intrauterine growth restriction(IUGR),is a complication of pregnancy where the fetus does not achieve its genetic growth potential.FGR is characterized by a pathological retardation of intrauterine growth velocity in the curve of intrauterine growth.However,the FGR definition is still debated,and there is a lack of a uniform definition in the literature.True IUGR,compared to constitutional smallness,is a pathological condition in which the placenta fails to deliver an adequate supply of oxygen and nutrients to the developing fetus.Infants with IUGR,compared to appropriately grown gestational age infants,have a significantly higher risk of mortality and neonatal complications with long-term consequences.Several studies have demonstrated how suboptimal fetal growth leads to long-lasting physiological alterations for the developing fetus as well as for the newborn and adult in the future.The long-term effects of fetal growth retardation may be adaptations to poor oxygen and nutrient supply that are effective in the fetal period but deleterious in the long term through structural or functional alterations.Epidemiologic studies showed that FGR could be a contributing factor for adult chronic diseases including cardiovascular disease,metabolic syndrome,diabetes,respiratory diseases and impaired lung function,and chronic kidney disease.In this review we discussed pathophysiologic mechanisms of FGR-related complications and potential preventive measures for FGR.
文摘Purpose: To accurately derive H0 from subatomic constants in abscence of any standard astronomy data. Methods: Recent astronomical data have determined a value of Hubble’s constant to range from 76.9+3.9-3.4+10.0-8.0 to 67.80 ± 0.77 (km/s)/Mpc. An innovative prediction of H0 is obtained from harmonic properties of the frequency equivalents of neutron, n0, in conjunction with the electron, e;the Bohr radius, α0;and the Rydberg constant, R. These represent integer natural unit sets. The neutron is converted from its frequency equivalent to a dimensionless constant,, where “h” = Planck’s constant, and “s” is measured in seconds. The fundamental frequency, Vf, is the first integer series set . All other atomic data are scaled to Vf as elements in a large, but a countable point set. The present value of H0 is derived and ΩM assumed to be 0. An accurate derivation of H0 is made using a unified power law. The integer set of the first twelve integers N12 {1,2,…,11,12}, and their harmonic fractions exponents of Vf represent the first generation of bosons and particles. Thepartial harmonic fraction, -3/4, is exponent of Vf which represents H0. The partial fraction 3/4 is associated with a component of neutron beta decay kinetic energy. Results: H0 is predicted utilizing a previously published line used to derive Planck time, tp. The power law line of the experimental H0 and tp conforms to the predicted line. Conclusions: H0 can be predicted from subatomic data related to the neutron and hydrogen.
基金L.T.-R.enjoys a“Post-MIR”predoctoral research grant from the Health Research Institute La Fe(IISLAFE).I.L.-C.and A.P.-G.enjoy Rio Hortega predoctoral grants from the Instituto de Investigación en Salud Carlos III(Ministry of Science,Spain).
文摘Extreme preterm infants(<28 weeks'gestation)often require positive pressure ventilation with oxygen during postnatal stabilization in the delivery room.To date,optimal inspired fraction of oxygen(FiO_(2))still represents a conundrum in newborn care oscillating between higher(>60%)and lower(<30%)initial FiO_(2).Recent evidence and meta-analyses have underscored the predictive value for survival and/or relevant clinical outcomes of the Apgar score and the achievement of arterial oxygen saturation measured by pulse oximetry≥85%at 5 minutes after birth.New clinical trials comparing higher versus lower initial FiO_(2)have been launched aiming to optimize postnatal stabilization of extreme preterm while avoiding adverse effects of hypoxemia or hyperoxemia.
文摘The Harmonic Neutron Hypothesis, HNH, has demonstrated that many of the fundamental physical constants including particles and bosons are associated with specific quantum integers, n. These integers define partial harmonic fractional exponents, 1 ± (1/n), of a fundamental frequency, Vf. The goal is to evaluate the prime and composite factors associated with the neutron n0, the quarks, the kinetic energy of neutron beta decay, the Rydberg constant, R, e, a0, H0, h, α, W, Z, the muon, and the neutron gluon. Their pure number characteristics correspond and explain the hierarchy of the particles and bosons. The elements and black body radiation represent consecutive integer series. The relative scale of the constants cluster in a partial harmonic fraction pattern around the neutron. The global numerical organization is related to the only possible prime factor partial fractions of 2/3, or 3/2, as pairs of 3 physical entities with a total of 6 in each group. Many other progressively resonant prime number factor patterns are identified with increasing numbers of smaller factors, higher primes, or larger partial fractions associated with higher order particles or bosons.
文摘The Harmonic Neutron Hypothesis, HNH, has demonstrated that many of the fundamental physical constants are associated with quantum integers, n, within a classic integer and partial harmonic fraction system, and follow a known two-dimensional, 2D, power law geometry. These are exponents of a fundamental frequency, vF, the basis of which is the annhilation frequency of the neutron, vn0. Our goal to a first approximation is to derive the frequency equivalents of the Rydberg constant, vR, the Bohr radius, va0, the electron, ve-, and the reciprocal fine structure constant, 1/α all from vn0, π, and a small set of prime integers only. The primes used in the derivations are respectively 2, 3, 5, 7, and 11. This is possible since it is known that the number 3 is associated with R, 5 with a0, 7 with e-, and 11 with 1/α. In addition, the interrelationships of the frequency ratio equivalents of these natural units with 2 and π are known, thus allowing for the derivation of any one from the others. Also the integer and partial fractions of a0, e-, and n0 define Planck time squared, tP2. An accurate estimate of tP2 from vF alone is also related to the integer 2 since gravity is a kinetic force. Planck time squared, tP2 scales the Y-axis, and vF scales the X-axis. In conclusion the quantum properties of hydrogen are derived from only the natural unit physical data of the neutron, to a relative precision ranging from 2.6 × 10-3 to 6.7 × 10-4. This supports the hypothesis that many of the fundamental constants are related to vn0.
文摘A number of solid tumors contain a distinct subpopulation of cells, termed cancer stem cells (CSCs) which represent the source for tissue renewal and hold malignant potential and which would be responsible for therapy resistance. Today, the winning goal in cancer research would be to find drugs to kill both cancer cells and cancer stem cells, while sparing normal cells. Osteosarcoma is an aggressive pediatric tumor of growing bones that, despite surgery and chemotherapy, is prone to relapse. We have recently selected from human osteosarcoma MG63 cells a cancer stem-like cell line (3AB-OS), which has unlimited proliferative potential, high levels of stemness-related markers, and in vivo tumorforming capacity in xenograft assays. Here, we have shown that 3AB-OS cells can differentiate in vitro into endoderm-, mesoderm-and ectoderm-derived lineages. Cell differentiation is morphological, molecular and functional. We propose that this model system of 3AB-OS differentiation in vitro might have a number of useful purposes, among which the study of molecular mechanisms of osteosarcoma origin, and the analysis of factors involved in specification of the various cell lineages. We still do not know either what are the shared and distinguishing characters between CSCs and normal stem cells, or what is the reason why the cancer stem cells, like the normal stem cells, have the ability to differentiate toward the derivatives of the primary germ layers. It is possible that each of the differentiation capability may be exploited by CSCs to supply their needs of growing and surviving in hostile microenvironment.
文摘Two main issues are crucial for neonatology at present： first, the increased rate of preterm delivery （〉 10%） especially in low and middle income countries or even in industrialized countries lacking a universal access to health care;
文摘We find that π represents dual attributes. One is within the purely mathematical domain and can be derived for example, from infinite series, among several other methods. The other is within a 2D geometric-physical domain. This paper analyzes several physical constants from an analogous perspective where they are defined solely by mathematical and 2D geometric properties independent of any actual physical scaling data. The constants are evaluated as natural unit frequency equivalents of the neutron, electron, Bohr radius, Rydberg constant, Planck’s constant, Planck time, a Black hole with a Schwarzschild radius, the distance light travels in one time unit;and the fine structure constant. These constants are defined within two inter-related harmonic domains. In the linear domain, the ratios of the frequency equivalents of the Rydberg constant, Bohr radius, electron;and the fine structure constant are related to products of 2 and π. In the power law domain, their partial harmonic fraction powers, and the integer fraction powers of the fundamental frequency for Planck time are known. All of the constants are then derived at the point where a single fundamental frequency simultaneously fulfills both domains independent of any direct physical scale data. The derived values relative errors from the known values range from 10-3 to 10-1 supporting the concept and method.
文摘Contralateral axillary metastasis (CAM) is a rare entity normally treated as a systemic disease. Recent publications have proposed aggressive surgical treatment with benefits to the patients in terms of survival. We present a case of a 74-year-old patient with a history of unilateral breast cancer, recurrence on the ipsilateral breast and then development of a CAM. The patient was treated with aggressive surgical treatment, but she developed an early recurrence of the disease with distant metastasis. There is limited evidence of the correct management of CAM, although proposed to treat it as a loco regional disease, individualized and multidisciplinary management is the best option for these patients.
文摘We report a case of a 40</span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;">year-old woman, second pregnancy, previous cesarean section due to intrauterine growth restriction and placenta accreta spectrum disorders. She was 25 weeks gestational age, admitted to the hospital 25 weeks gestational age, diagnosed with fetal death. Initial conservative management attempt with uterine preservation progresses to complications requiring total hysterectomy followed by a rare outcome: pelvic thrombi with uterine necrosis, with its associated clinical complications.
文摘<strong>Introduction:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Prematurity is a public health problem in Brazil, with 12% of deliveries occurring before 37 weeks of gestation. The measurement of the cervix in the second trimester is already established as a method of screening for prematurity and some studies point out advantages to start this screening in the first trimester. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> To define the correlation between the length of the endocervix by transvaginal ultrasound in the first trimester (11 to 14 weeks) with spontaneous early deliveries. </span><b><span style="font-family:Verdana;">Method:</span></b><span style="font-family:Verdana;"> A prospective and observational study realized in a suplementar and private ultrasound clinic and hospital of Porto Alegre, Brazil between 2019-2020. Ultrasound screening of cervix was performed in singleton pregnancies in first and second trimester of pregnancy and correlated with age of delivery. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> 142 pregnant women were studied, 80% were in the first pregnancy. The average age was 33.8 years. The rate of prematurity was 18% before 37 weeks and 4% before 34 weeks. The average of cervix measured in the first and second trimesters in deliveries before 34 weeks was 32.7 mm and 29.3 mm, respectively. In term deliveries the median cervical length was 38.8 mm and 37.8 mm, respectively. When analyzing the measurements of the cervix in the second trimester, the cervix was smaller (p = 0.008) among deliveries below 34 weeks (29</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">mm) than deliveries after 37 weeks. No statistically related differences were found between preterm birth and first trimester cervix measurements. </span><b><span
基金supported by the Health Research Institute Carlos III(Spanish Ministry of Economy,Industry and Innovation)and co-funded by the European Union[PI18/01292,CD19/00037,CM20/00187,and CPII21/00003]the Health Research Institute La Fe,Spain[grant number 2019-050-1_CRC].
文摘Severe acute respiratory syndrome coronavirus 2(SARSCoV-2)is a novel beta coronavirus that causes coronavirus disease 2019(COVID-19),a severe infectious respiratory disease.In January 2020,the World Health Organization(WHO)declared the outbreak a public health emergency of international concern,and in March 2020.
文摘BACKGROUND The coronavirus disease 2019(COVID-19) pandemic produced changes in intensive care units(ICUs) in patient care and health organizations. The pandemic event increased patients’ risk of developing psychological symptoms during and after hospitalisation. These consequences also affected those family members who could not access the hospital. In addition, the initial lack of knowledge about the virus and its management, the climate of fear and uncertainty, the increased workload and the risk of becoming infected and being contagious, had a strong impact on healthcare staff and organizations. This highlighted the importance of interventions aimed at providing psychological support to ICUs, involving patients, their relatives, and the staff;this might involve the reorganisation of the daily routine and rearrangement of ICU staff duties.AIM To conduct a systematic review of psychological issues in ICUs during the COVID-19 pandemic involving patients, their relatives, and ICU staff.METHODS We investigated the PubMed and the ClinicalTrials.gov databases and found 65 eligible articles,upon which we commented.RESULTS Our results point to increased perceived stress and psychological distress in staff, patients and their relatives and increased worry for being infected with severe acute respiratory syndrome coronavirus-2 in patients and relatives. Furthermore, promising results were obtained for some psychological programmes aiming at improving psychological measures in all ICU categories.CONCLUSION As the pandemic limited direct inter-individual interactions, the role of interventions using digital tools and virtual reality is becoming increasingly important. All considered, our results indicate an essential role for psychologists in ICUs.
