Refsgaardotte5353
For decades, the class of anabolic androgenic steroids has represented the most frequently detected doping agents in athletes' urine samples. Roughly 50% of all adverse analytical findings per year can be attributed to anabolic androgenic steroids, of which about 2/3 are synthetic exogenous steroids, where a qualitative analytical approach is sufficient for routine doping controls. For the remaining 1/3 of findings, caused by endogenous steroid-derived analytical test results, a more sophisticated quantitative approach is required, as their sheer presence in urine cannot be directly linked to an illicit administration. Here, the determination of urinary concentrations and concentration ratios proved to be a suitable tool to identify abnormal steroid profiles. Due to the large inter-individual variability of both concentrations and ratios, population-based thresholds demonstrated to be of limited practicability, leading to the introduction of the steroidal module of the Athlete Biological Passport. The passport enabled the generation of athlete-specific individual reference ranges for steroid profile parameters. Besides an increase in sensitivity, several other aspects like sample substitution or numerous confounding factors affecting the steroid profile are addressed by the Athlete Biological Passport-based approach. This narrative review provides a comprehensive overview on current prospects, supporting professionals in sports drug testing and steroid physiology.Now that the majority of medical personnel have been vaccinated against COVID-19 or are at least willing to be vaccinated, it is necessary to discuss whether employees can be required to be vaccinated. Can employers demand proof of vaccination, and are there consequences under labor law for refusing to vaccinate? Currently, there is no general legal COVID-19 vaccination requirement. Any mandatory vaccination is an encroachment on the fundamental right to physical integrity and to informational self-determination. This encroachment on fundamental rights must be weighed up in each individual case.
The use of peroral endoscopic myotomy (POEM) for achalasia has a high incidence of post-procedural gastroesophageal reflux (GER). PD0325901 Transoral incisionless fundoplication (TIF) may be an ideal endoscopic treatment. We report our experience with the use of post-POEM TIF.
In this multicenter retrospective study, post-POEM patients with GER who underwent TIF were included. The study end points were (i) technical success; (ii) safety; (iii) effectiveness (changes in symptoms, scores, proton pump inhibitor [PPI] use, pH studies).
12 patients underwent TIF after POEM, nine of whom had daily symptoms, with 91.7% requiring twice daily (BID) PPIs. Technical success was achieved in all patients. Two adverse events occurred. There were significant decreases in the percentage of patients on BID PPIs (
= 0.03), frequency of daily symptoms (
= 0.03), Reflux Severity Index questionnaire, and GERD Health-related Quality of Life scores (
= 0.03 and
= 0.003; n = 6). pH studies performed in seven of the patients showed a significant reduction in the mean DeMeester score (
= 0.05) and mean percentage acid exposure time (
= 0.04).
Our experience suggests that TIF may be effective and safe in treating GER after POEM. Larger prospective trials are needed.
Our experience suggests that TIF may be effective and safe in treating GER after POEM. Larger prospective trials are needed.
Intratumoral heterogeneity is a hallmark of diffuse gliomas. DNA methylation profiling is an emerging approach in the clinical classification of brain tumors. The goal of this study is to investigate the effects of intratumoral heterogeneity on classification confidence.
We used neuronavigation to acquire 133 image-guided and spatially-separated stereotactic biopsy samples from 16 adult patients with a diffuse glioma (7 IDH-wildtype and 2 IDH-mutant glioblastoma, 6 diffuse astrocytoma, IDH-mutant and 1 oligodendroglioma, IDH-mutant and 1p19q codeleted), which we characterized using DNA methylation arrays. Samples were obtained from regions with and without abnormalities on contrast enhanced T1 weighted and fluid-attenuated inversion recovery MRI. Methylation profiles were analyzed to devise a three-dimensional reconstruction of (epi)genetic heterogeneity. Tumor purity was assessed from clonal methylation sites.
Molecular aberrations indicated that tumor was found outside imaging abnormalities, underlining the infiltrative nature of this tumor and the limitations of current routine imaging modalities. We demonstrate that tumor purity is highly variable between samples and explains a substantial part of apparent epigenetic spatial heterogeneity. We observed that DNA methylation subtypes are often, but not always, conserved in space taking tumor purity and prediction accuracy into account.
Our results underscore the infiltrative nature of diffuse gliomas and suggest that DNA methylation subtypes are relatively concordant in this tumor type, although some heterogeneity exists.
Our results underscore the infiltrative nature of diffuse gliomas and suggest that DNA methylation subtypes are relatively concordant in this tumor type, although some heterogeneity exists.
This study explores sponsored tobacco advocacy messages on Facebook and Instagram by (1) Examining differences in message performance metrics, funding sources, and audience characteristics of anti- and pro-tobacco messages in the United States, and (2) Characterizing audience exposure to anti- and pro-tobacco message themes across different age-groups and by gender.
The analytic sample consisting of 375 tobacco-advocacy-related messages on Instagram and/or Facebook in the United States during May 29, 2020 to July 26, 2020, was obtained from the Facebook Ad Library API. Chi-square tests compared differences in anti- and pro-tobacco messages by potential reach, impressions, approximate spend $, social media platform type, average duration of delivery, type of funding sources, and audience age and gender exposure. Percentage distribution of message themes and audience exposure by age and gender were also examined.
Anti-tobacco messages (n=334, 89.07%) exceeded pro-tobacco messages (n=41, 10.93%) overall. Anti-tobacco messages had lower potential reach, received a lower proportion of impressions, and spent a lower proportion of money per message.
