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Background Mosquito allergy is common in tropical countries but remains under-diagnosed. This may be due to the lack of knowledge and diagnostic tools for tropical mosquito allergens. Objective We aimed to characterize allergens from tropical mosquito species and investigate IgE reactivity in mosquito-allergic patients to the salivary gland proteins from these mosquitoes. Methods Salivary gland extract (SGE) from 4 mosquito species, highly distributed in the tropics, including Aedes aegypti, Aedes albopictus, Culex quinquefasciatus, and Anopheles dirus b, were studied. SGE-specific IgE and IgG ELISA were developed, and serum from 64 mosquito-allergic and 22 non-allergic healthy control subjects was assayed. Further investigations using IgE-immunoblots followed by mass spectrometry analysis were performed to identify and characterize allergens from each species. Results Mosquito-allergic subjects have detectable serum IgE to SGE derived from local mosquito species, while the IgE levels to Aedes communis using commercially available ELISA were mostly minimal. IgE-immunoblot analysis and mass spectrometry identified 5 novel mosquito allergens from A. albopictus (Aed al 2, Aed al 3), C. quinquefasciatus (Cul q 2.01, Cul q 3), and A. dirus b (Ano d 2). Interestingly, 4 of the 5 new allergens belong to the D7 protein family. Conclusions & clinical relevance Five novel allergens from 3 tropical mosquito species were characterized. The majority of mosquito-allergic subjects who live in the tropics have IgE reactivity to these allergens. Our study paves the way for the development of diagnostic tests, component-resolved diagnostics, and future immunotherapy for mosquito allergy in tropical countries. © 2020 The Authors.Diagnosis of idiopathic mediastinal fibrosis was done by exclusion in a 54-year-old woman with dyspnoea, chest pain, cough and fatigue showing positivity of 2-deoxy-2-[18F]fluoro-D-glucose positron-emission tomography/computed tomography total body imaging which turned out to normal after six and eighteen months of prednisone and pirfernidone treatment. © 2020 The Authors. Published by Elsevier Inc. on behalf of University of Washington.Endometrial cancer arising from adenomyosis (EC-AIA) is extremely rare, and the typical magnetic resonance imaging (MRI) findings of EC-AIA have not been established. We report a case of EC-AIA that was detected preoperatively on MRI and conduct a literature review of the MRI findings of EC-AIA. © 2020 The Authors. Published by Elsevier Inc. on behalf of University of Washington.Background Genetic counselling (GC) is an integral component in the care of individuals at risk for hereditary cancer predisposition syndromes (CPS). In many jurisdictions, access to timely counselling and testing is limited by financial constraints, by the shortage of genetics professionals and by labor-intensive traditional models of individual pre and post-test counselling. There is a need for further research regarding alternate methods of GC service delivery and implementation. This quality improvement project was initiated to determine if pretest group GC followed immediately by a 'mini' individual session, would be acceptable to patients at risk for hereditary breast and colon cancer. Methods Patients on waitlists for GC at the Provincial Medical Genetics Program in St. John's, NL, Canada (n = 112), were contacted by telephone and offered the option of a group counselling session (GGC), followed by a "mini" individual session, versus (TGC) traditional private appointments. GGC sessions consisted of a c this model. At the end of the pilot project, the waitlist for counselling/testing was reduced by 12 months. Conclusions Group pre-test genetic counselling combined with immediate "mini" individual session is strongly supported by patients and reduces wait times. Additional formal investigation of this approach in larger numbers of patients is warranted. © The Author(s). 2020.Objective Nearly all studies treat the Five Facet Mindfulness Questionnaire as five independent scales (one measuring each of the five facets), yet almost no methodological work has examined the psychometric structure of the facets independently. We address this gap using factor analytic methods. Methods Exploratory and confirmatory factor models were fit to item response data from a sample of 522 adults recruited online. Findings were replicated in a sample of 454 adults receiving aftercare for substance use disorder. Results Parallel analysis suggested multiple factors for all five facets, in both samples. Exploratory factor models suggested the presence of method factors on the acting with awareness (items using the term "distraction") and describing facets (items that were reverse-scored). Confirmatory factor models fit poorly for all facets, in both samples. In follow-up analyses, model fit improved substantially on the acting with awareness and describing facets when method factors were included in a bifactor model. Model fit was also better for the facets of FFMQ short forms than for the full-length facets. The short-form facets and original facets correlated similarly with external criteria in both samples. Conclusions None of the FFMQ facets fit a unidimensional factor model; yet, follow-up analyses suggested each can be considered substantively unidimensional. Initial tests suggest the facets' multidimensionality did not materially impact their relation to other psychological constructs, suggesting multidimensionality can be ignored for some purposes. The use of short-form facets or latent variable models (e.g., bifactor specifications) are both viable solutions for addressing multidimensionality when desired.Background Few studies examined associations between depressive symptoms and metabolic syndrome (MetS) among older Chinese adults. Considering that the prevalence of depressive symptoms is high in older Chinese adults, we aimed to examine associations of depressive symptoms with MetS and its components in older Chinese adults. Methods Data from a community-based cross-sectional study of 4579 Chinese adults aged 60 years or older were analyzed. Depressive symptoms were assessed using the nine-item Patient Health Questionnaire. The presence of MetS was defined based on the Adult Treatment Panel III criteria, which include obesity, reduced blood high-density lipoprotein, high blood pressure (BP), elevated fasting plasma glucose and hypertriglyceridemia. A participant was considered as having MetS if he or she met at least three of the above-mentioned criteria. Results In all participants, depressive symptoms were related to elevated fasting plasma glucose (≥ 7.0 mmol/L) (adjusted odds ratio [OR] = 1.50, 95% confidence interval [CI] [1.00-2.20]) and diabetes (adjusted OR = 1.50, 95% CI [1.01-2.20]). The associations of depressive symptoms with MetS and its components were not significant among women. However, there was a negative association between depressive symptoms and elevated systolic BP (≥ 130 mm Hg) (OR = 0.59, 95% CI [0.4-0.9]), and similar findings were observed after adjusting for lifestyle-related variables in men. Conclusions In older Chinese adults, depressive symptoms were negatively associated with elevated systolic BP in men while these findings were not found in women. © The Author(s) 2020.Objective This study aimed to establish a clinical prognostic nomogram for predicting major adverse cardiovascular events (MACEs) after primary percutaneous coronary intervention (PCI) among patients with ST-segment elevation myocardial infarction (STEMI). Methods Information on 464 patients with STEMI who performed PCI procedures was included. After removing patients with incomplete clinical information, a total of 460 patients followed for 2.5 years were randomly divided into evaluation (n = 324) and validation (n = 324) and validation (. Results Apelin-12 change rate, apelin-12 level, age, pathological Q wave, myocardial infarction history, anterior wall myocardial infarction, Killip's classification > I, uric acid, total cholesterol, cTnI, and the left atrial diameter were independently associated with MACEs (all P less then 0.05). After incorporating these 11 factors, the nomogram achieved good concordance indexes of 0.758 (95%CI = 0.707-0.809) and 0.763 (95%CI = 0.689-0.837) in predicting MACEs in the evaluation and validation cohorts, respectively, and had well-fitted calibration curves. The decision curve analysis (DCA) revealed that the nomogram was clinically useful. Conclusions We established and validated a novel nomogram that can provide individual prediction of MACEs for patients with STEMI after PCI procedures in a Chinese population. This practical prognostic nomogram may help clinicians in decision making and enable a more accurate risk assessment. Copyright © 2020 Enfa Zhao et al.Background Atherothrombotic disease, including coronary artery disease (CAD) and peripheral artery disease (PAD), can lead to cardiovascular (CV) events, such as myocardial infarction, stroke, limb ischemia, heart failure, and CV death. Aim Evaluate the humanistic and economic burden of CAD and PAD and identify unmet needs through a comprehensive literature review. Methods Relevant search terms were applied across online publication databases. Studies published between January 2010 and August 2017 meeting the inclusion/exclusion criteria were selected; guidelines were also included. Two rounds of screening were applied to select studies of relevance. Blasticidin S cost Results Worldwide data showed approximately 5-8% prevalence of CAD and 10-20% prevalence of PAD, dependent on the study design, average age, gender, and geographical location. Data from the REACH registry indicated that 18-35% of patients with CAD and 46-68% of patients with PAD had disease in one or more vascular beds. Use of medication to control modifiable CV risk factors was variable by country (lower in France than in Canada); statins and aspirin were the most widely used therapies in patients with chronic disease. Survival rates have improved with medical advancements, but there is an additional need to improve the humanistic burden of disease (i.e., associated disability and quality of life). The economic burden of atherothrombotic disease is high and expected to increase with increased survival and the aging population. Conclusion CAD and PAD represent a substantial humanistic and economic burden worldwide, highlighting a need for new interventions to reduce the incidence of atherothrombotic disease. Copyright © 2019 Rupert Bauersachs et al.Background Sexually exploited youth are disconnected from societal tethers and need support systems, which makes them some of the most vulnerable of youth. This heightened level of vulnerability increases their risk for violence, abuse, ongoing sexual exploitation and all its sequelae. The purpose of this study was to examine an evidence-based intervention called STRIVE (support to reunite, involve and value each other) that has been a successful family re-engagement strategy with newly homeless youth. We sought to explore its contextual relevance for youth with risk factors for sexual exploitation and identify necessary adaptations to reduce risk factors for sexual exploitation. We deliberately took an intersectional approach in conducting this study. Methods Six community-based focus groups were conducted with youth at risk for sexual exploitation and their service providers. Each group was recorded, transcribed, coded, and thematically analyzed. Results Results from 29 youth and 11 providers indicate that there are unique considerations that must be taken into account while working with youth at risk for sexual exploitation to ensure effective service delivery and/or ethical research.

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