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To figure out the impact of national health insurance program and treatment modalities on the clinical outcomes of patients with retinoblastoma.
Retrospective cohort study.
Enrolled patients were classified into three groups according to the time period in which their initial diagnosis was performed patients diagnosed before 1995 (group 1), patients diagnosed in the time period 1995-2010 (group 2), patients diagnosed after 2010 (group 3). Comparison was made of clinical features including presenting signs, tumor spreading, and treatment modes. Survival and globe salvage rates were analyzed within each group.
There were 157 patients (202 eyes) enrolled from 1978 to 2015. The overall mortality rate was 24.2%. The overall 5-year survival rate was 63.4%, 73.8%, 89.1% in the three time periods respectively (P = 0.007). The 5-year survival improved continuously in both unilateral and bilateral disease (P = 0.057; P = 0.015). Patients without extraocular spreading or diagnosed before 2years of age had a better 5- year survival of 97.4% and 81.1% respectively. The globe salvage rate improved from 8.2%, 14.5%, to 35.1% (P < 0.001). The globe salvage rate was 46.9% in patients who received ophthalmicarterychemosurgery(OAC) and 6.4% in patients not received OAC.
Improvement of survival and globe salvage rate was observed over time periods. National health insurance program has made medical care easily accessible to the public, leading to earlier diagnosis and treatment. Different treatment modes could achieve a better clinical outcome; among the new treatment modalities, OAC played an important role.
Improvement of survival and globe salvage rate was observed over time periods. National health insurance program has made medical care easily accessible to the public, leading to earlier diagnosis and treatment. Different treatment modes could achieve a better clinical outcome; among the new treatment modalities, OAC played an important role.
Pouchitis is the most common long-term complication in patients requiring colectomy ileal pouch-anal anastomosis with medically refractory ulcerative colitis or colitis-associated neoplasia. A previous small case series suggests associated between portal vein thrombosis (PVT) and ischemic pouchitis.
To evaluate the association between PVT and other demographic and clinical factors and pouchitis.
We used Explorys Inc., a population-based database, to search medical records between 1999 and 2020 with SNOMED-CT code criteria for "construction of pouch" and "ileal pouchitis." Patients with pouchitis were compared to those with previous pouch construction without pouchitis. Factors associated with pouchitis identified with univariable analysis were introduced into a multivariable model. A post hoc analysis further stratified demographical findings of the association between PVT and pouchitis.
We identified 7900 patients with ileal pouchitis (7.5%) and 97,510 with pouch construction without pouchitis. In musk of pouchitis.
Amid the COVID-19 pandemic, medical education organizations endorsed a virtual recruitment format, representing a stark change from traditional in-person interviews. We aimed to identify the attitudes and perceptions of Gastroenterology Fellowship Program Directors (PDs) and applicants regarding the virtual interview experience and the role of virtual interviews (VI) in the future.
We designed separate surveys targeting PDs and applicants using the Qualtrics software. At the end of the interview season, we e-mailed both survey links to all PDs and requested that they forward the applicant survey to their interviewed candidates. Surveys were voluntary and anonymous. Descriptive statistics were used to analyze the data with results presented as percentages.
A total of 29.7% of PDs completed the survey. Compared to traditional interviews, VI were viewed by 46.5% of PDs to be very suboptimal or suboptimal. Yet, 69.1% envisioned a role for VI in the future. A total of 14.2% of applicants completed the survey. check details Compared to traditional interviews, VI were viewed by 42.3% of applicants to be very suboptimal or suboptimal. However, 61.8% saw a future role for VI. While both applicants and PDs reported that establishing an interpersonal connection was a disadvantage with VI, applicants placed more emphasis on this need for connection (p = 0.001).
Overall, PDs and applicants report mixed views with regard to VI but anticipate that it may continue to have a future role. VI may augment future recruitment cycles with care taken to not disadvantage applicants, who rely heavily on the interview process to create personal connections with programs.
Overall, PDs and applicants report mixed views with regard to VI but anticipate that it may continue to have a future role. VI may augment future recruitment cycles with care taken to not disadvantage applicants, who rely heavily on the interview process to create personal connections with programs.Two novel Gram-negative bacterial strains BT442T and BT584 were isolated from dry soil collected in mountains Busan and Guri, Korea during wintertime. Phylogenetic analysis based on 16S rRNA gene sequences revealed that strains BT442T and BT584 both belong to a distinct lineage within the genus Hymenobacter (family Hymenobacteraceae, order Cytophagales, class Cytophagia). Strain BT442T was closely related to Hymenobacter soli PB17T (98.0% 16S rRNA gene similarity) and Hymenobacter terrae POA9T (97.6%). No other recognized bacterial species showed more than 97% 16S rRNA gene sequence similarity to strains BT442T. The genome size of strain BT442T was 5,143,362 bp. Bacterial growth was observed at 10-30 °C (optimum 25 °C), pH 6.0-8.0 (optimum pH 6.0) in R2A agar and in the presence up to 1% NaCl. The major cellular fatty acids of strains BT442T and BT584 were iso-C150, anteiso-C150 and summed feature 3 (C161 ω6c / C161 ω7c). In addition, their predominant respiratory quinone was MK-7. The major polar lipids of strains BT442T and BT584 were identified to be phosphatidylethanolamine, aminophospholipid, and aminolipid. Based on the biochemical, chemotaxonomic, and phylogenetic analyses, strains BT442T and BT584 are novel bacterial species within the genus Hymenobacter, and the proposed name is Hymenobacter negativus. The strain type of Hymenobacter negativus is BT442T (= KCTC 72902T = NBRC XXXXT).Idiomatic expressions (IE) are groups of words whose meaning is different from the sum of its components. Neural mechanisms underlying their processing are still debated, especially regarding lateralization, main structures involved, and whether this neural network is independent from the spoken language. To investigate the neural correlates of IE processing in healthy Spanish speakers.Twenty one native speakers of Spanish were asked to select one of 4 possible meanings for IE or literal sentences. fMRI scans were performed in a 3.0T scanner and processed by SPM 12 comparing IE vs. literal sentences. Laterality indices were calculated at the group level. IE activated a bilateral, slightly right-sided network comprising the pars triangularis and areas 9 and 10. In the left hemisphere (LH) the pars orbitalis, superior frontal, angular and fusiform gyrus. In the right hemisphere (RH) anterior insula, middle frontal, and superior temporal gyrus. This network reveals the importance of the RH, besides traditional LH areas, to comprehend IE. This agrees with the semantic coding model the LH activates narrow semantic fields choosing one single meaning and ignoring others, and the RH detects distant semantic relationships, activating diffuse semantic fields. It is also in line with the configuration hypothesis both meanings, literal and figurative, are executed simultaneously, until the literal meaning is definitively rejected and the figurative one is accepted. Processing IE requires the activation of fronto-temporal networks in both hemispheres. The results concur with previous studies in other languages, so these networks are independent from the spoken language. Understanding these mechanisms sheds light on IE processing difficulties in different clinical populations and must be considered when planning resective surgery.Maternal hypertensive disorders during pregnancy (HDP) have been associated with neuropsychiatric problems in offspring. We aim to investigate the associations between specific types of maternal HDP and offspring neurodevelopmental disorders and further examine whether the timing of onset and severity of HDP would affect these associations. The study population consisted of 4,489,044 live-born singletons in Denmark during 1978-2012 and Sweden during 1987-2010. Maternal HDP was categorized into chronic hypertension, gestational hypertension, and pre-eclampsia; pre-eclampsia was further stratified according to timing (early-onset, late-onset), or severity (moderate, severe) of the disease. Neurodevelopmental disorders, including attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and intellectual disability (ID), were defined by ICD-coded register diagnosis. Cox regression was used to calculate hazard ratios (HR) while adjusting for potential confounders, and sibling analyses assessed the influence of unmeasured shared familial factors. Maternal HDP was associated with increased risks of ADHD (HR, 1.24; 95% confidence interval [CI], 1.20-1.28), ASD (1.29 [1.24-1.34]), and ID (1.58 [1.50-1.66]) in offspring, respectively, which was mostly driven by pre-eclampsia. The strongest associations were observed for early-onset and severe pre-eclampsia, and the corresponding HRs for ADHD, ASD and ID were 1.93 [1.73-2.16], 1.86 [1.61-2.15], and 3.99 [3.42-4.65], respectively. The results were similar in the sibling analyses. The associations between maternal HDP and offspring neurodevelopmental disorders were consistent across the subgroups of sex, preterm status, parity, maternal age and psychiatric disorders. Maternal HDP, especially early-onset pre-eclampsia, are associated with increased risks of ADHD, ASD, and ID in particular, independent of shared familial factors.
The current EU LULUCF regulation calls for member state-specific Forest Reference Levels (FRLs) for benchmark in the accounting of greenhouse gas emissions and removals of managed forest land during the compliance period (2021-2030). According to the technical guidance on developing and reporting the FRLs, it could be actualized by projecting a ratio of harvested to total available biomass. We tested how the initial age distribution may affect the aforementioned ratio by simulating the continuation of forest management based on several descriptive shapes of forest age class distribution.
Our simulations suggest that when the FRLs are prepared by employing the harvest ratio and forest management is assumed strictly age dynamics driven, the shape of the initial forest age class distribution gives rise to computational sinks or sources of carbon in managed forest land. Harvests projected according to the ratio corresponded those resulting from the age dynamics only in the case of uniform age distribution.
The result calls for a better consideration of variation in initial states between countries when determining the future LULUCF regulation. Our exercise demonstrates how generic simulations in a standardized modeling framework could help in ex-ante impact assessment of proposed changes to the LULUCF regulation.
The result calls for a better consideration of variation in initial states between countries when determining the future LULUCF regulation. Our exercise demonstrates how generic simulations in a standardized modeling framework could help in ex-ante impact assessment of proposed changes to the LULUCF regulation.
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