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Trial and error heating up as well as legacy effects in actual dynamics following a pair of hurricane disorder inside a damp tropical natrual enviroment.
The relationship between the microcirculation patterns and patient prognosis was analyzed by Kaplan-Meier method. RESULTS All 4 microcirculation patterns were observed in both GBM clinical specimens and xenograft tissues. EDVs were detected in all tissue samples, while the other three patterns were observed in a small number of tissue samples (ECMDVs in 27.5%, GDVs in 43.8%, and MVs in 52.5% tissue samples). GDV-positive patients had a median survival of 9.56 months versus 13.60 months for GDV-negative patients (P = 0.015). In MGMT promoter-methylated cohort, GDV-positive patients had a median survival of 6.76 months versus 14.23 months for GDV-negative patients (P = 0.022). CONCLUSION GDVs might be a negative predictor for the survival of GBM patients, even in those with MGMT promoter methylation. © 2020 The Authors. Cancer Communications published by John Wiley & Sons Australia, Ltd. on behalf of Sun Yat-sen University Cancer Center.OBJECTIVE Twin pregnancies have a significantly higher perinatal mortality than singleton pregnancies and current classification systems for perinatal death lack twin-specific categories, potentially leading to loss of important information regarding cause of death. We introduce and test a classification system designed to assign a cause of death in twin pregnancies (CoDiT). DESIGN Retrospective cross-sectional study. SETTING Tertiary maternity unit in England with a perinatal pathology service. POPULATION Twin pregnancies in the West Midlands affected by fetal or neonatal demise of one or both twins between 1st January 2005 and 31st December 2016 in which post-mortem examination was undertaken. METHODS A multidisciplinary panel designed CoDiT by adapting the most appropriate elements of singleton classification systems. The system was tested by assigning cause of death in 265 fetal and neonatal deaths from 144 twin pregnancies. Cause of death was validated by another obstetrician blinded to the original classification. MAIN OUTCOME MEASURES Inter-rater, intra-rater, inter-disciplinary agreement and cause of death. RESULTS Cohen's Kappa demonstrated "strong" (>0.8) inter-rater, intra-rater and inter-disciplinary agreement (95% CI 0.70-0.91). The commonest cause of death irrespective of chorionicity was the placenta; twin-to-twin transfusion syndrome (TTTS) was the commonest placental cause in monochorionic twins and acute chorioamnionitis in dichorionic twins. CONCLUSIONS This novel classification system records causes of death in twin pregnancies from post-mortem reports with high inter-user agreement. We highlight differences in aetiology of death between monochorionic and dichorionic twins. This article is protected by copyright. learn more All rights reserved.Total parenteral nutrition (TPN) is a life-saving therapy administered to millions of patients. However, it is associated with significant adverse effects, namely liver injury, risk of infections, and metabolic derangements. In this review, we first identify the underlying causes of TPN-associated adverse effects, specifically gut atrophy, dysbiosis of the intestinal microbiome, leakage of the epithelial barrier with bacterial invasion and inflammation. We analyze the role of the bile acid receptors farnesoid X receptor and Takeda G protein-coupled receptor, of pleiotropic hormones and growth factors, and further scrutinize the mechanisms of insulin resistance, namely the lack of insulinotropic and insulinomimetic signaling of gut-originating incretins as well as the administration of potentially toxic phytosterols and pro-inflammatory fatty acids mainly released from soybean oil-based lipid emulsions used for TPN. Finally, we propose novel approaches in the design of next generation lipid delivery systems by modifying the physicochemical properties of lipid emulsions, the use of lipid emulsions generated from sustainable oils with favorable ratios of anti-inflammatory n-3 to pro-inflammatory n-6 fatty acids, beneficial adjuncts to TPN, and concomitant pharmacotherapies to mitigate TPN-associated adverse effects. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.Cancer is still a major health problem in China although numerous efforts have been made for its prevention and control. Findings from this study showed that lung cancer remains the most common type of cancer diagnosed, and was attributed to nearly 30% of all cancer-related deaths. The incidence of the five most common cancers, in China, in 2015, including cancers of the lungs, stomach, colorectum, liver and breast, accounted for almost 60% of all cancers diagnosed. The high cancer burden in China highlights the need for further improvement in health education, professional training and the building up an anti-cancer network for introducing and implementing sustainable actions for cancer control. © 2020 The Authors. Cancer Communications published by John Wiley & Sons Australia, Ltd. on behalf of Sun Yat-sen University Cancer Center.Chronic illness burdens individuals, organizations and society, costing the US $3.5 trillion annually. Transposed from the engineering industry, condition-based maintenance is a novel concept that holds great promise for alleviating this burden by enhancing current health care delivery methods. Aims of this concept analysis include, (a) develop an operational definition for the term condition-based maintenance and (b) discuss the applicability and effectiveness of condition-based maintenance as applied to health care. A search of engineering and health care literature was completed. The search term "condition-based maintenance" was entered into the PubMed, Wiley Interscience Journals, CINAHL, Journals@Ovid, ProQuest Nursing & Allied Health Source, and Emerald databases. A review of the literature was completed to identify the qualities of condition-based maintenance. Utilizing the Walker and Avant method, antecedents, characteristics, and consequences were identified. A conceptual model of condition-based maintenance was developed encompassing two antecedents, four characteristics, and three consequences. Furthermore, a theoretical definition of condition-based maintenance was derived. Focus on the positive effects of proactively monitoring symptoms among chronically-ill persons is needed. Condition-based maintenance advances the National Institute of Nursing Research's focus on symptom science through the development of personalized strategies to treat and prevent the adverse symptoms of illness. © 2020 Wiley Periodicals, Inc.
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