Pseudoacromegaly

© 2018 Elsevier Inc. Individuals with acromegaloid physical appearance or tall stature may be referred to endocrinologists to exclude growth hormone (GH) excess. While some of these subjects could be healthy individuals with normal variants of growth or physical traits, others will have acromegaly or pituitary gigantism, which are, in general, straightforward diagnoses upon assessment of the GH/IGF-1 axis. However, some patients with physical features resembling acromegaly – usually affecting the face and extremities –, or gigantism – accelerated growth/tall stature – will have no abnormalities in the GH axis. This scenario is termed pseudoacromegaly, and its correct diagnosis can be challenging due to the rarity and variability of these conditions, as well as due to significant overlap in their characteristics. In this review we aim to provide a comprehensive overview of pseudoacromegaly conditions, highlighting their similarities and differences with acromegaly and pituitary gigantism, to aid physicians with the diagnosis of patients with pseudoacromegaly.PM is supported by a clinical fellowship by Barts and the London Charity. Our studies on pituitary adenomas and related conditions received support from the Medical Research Council, Rosetrees Trust and the Wellcome Trust

1 PLACING SHIBBOLETHS AT THE INSTITUTIONAL GATE: LADO TESTS AND THE CONSTRUCTION OF ASYLUM SEEKERS' IDENTITIES

LADO tests and the construction of asylum seekers ’ identities b

Ouders en kinderen in (kans)armoede : een onderzoek naar de beleving van de leefsituatie van gezinnen in (kans)armoede met kinderen tussen 0 en 3 jaar in Ieper

Een onderzoeksproject in opdracht van en samenwerking met OCMW/Stad Ieper (2014-2015) Het OCMW van Ieper wil intensief in te zetten op het bestrijden van kinderarmoede in haar werkingsgebied. Eén van de actiepunten is het in kaart brengen van kinderarmoede in Ieper en de perceptie van de doelgroep op hun eigen leefwereld en de bestaande hulpverlening. Hiertoe werd een onderzoek uitgevoerd met als doelstelling het opstellen van tien beleidsaanbevelingen voor de stad en het OCMW van Ieper die aanzet geven tot concrete structurele acties in de bestrijding van kinderarmoede. Deze doelstelling werd vertaald in volgende onderzoeksvragen : Kwantitatief onderzoek: een interpretatie van het bestaande cijfermateriaal vanuit Steunpunt Sociale Planning, Kinderarmoedebarometer, OCMW, Integratiemonitor, Kind en Gezin, Jeugddienst,… Kwalitatief onderzoek: een onderzoek naar de beleving van ouders en kinderen in armoede : Hoe beleven en ervaren kansarme gezinnen hun leefsituatie? Hoe beleven en ervaren kansarme gezinnen het hulpverleningsaanbod van de bestaande lokale diensten? Hoe gaan kansarme ouders en kinderen met hun leefwereld om ?status: publishe

Duurzaam tegen de (voedselverlies)stroom in! Deel 1: Weet-boekje

In dit deel kom je te weten wat we precies begrijpen onder ‘bewust omgaan met voeding’ op school. We focussen beknopt op de principes van gezonde voeding en duurzame voeding. De problematiek van voedselverliezen stond in het onderzoek centraal en wordt gekaderd met feiten en cijfers. Je maakt kennis met een model voor het werken aan gedragsverandering. Krijgt inzicht in hoe gedrag tot stand komt en welke factoren daarin een rol spelen. Dit kan jou helpen wanneer je straks wil inzetten op veranderingen. Daarnaast verwijzen we kort naar de wetgeving met betrekking tot voedselveiligheid. Dit enkel om aandacht te leggen bij het feit dat ‘niet alles kan en mag’. Soms denken we er aan voedseloverschotten te herbestemmen als dierenvoeder, maar daar zijn regels voor en zijn er strikte beperkingen.status: accepte

Using fully variable valve control for cylinder-individual reference tracking with emission-optimal internal exhaust gas recirculation

A fully variable valve train significantly increases the degree of freedom of the control of internal combustion engines. Cylinder deactivation, thermal management, alternative combustion strategies, and minimized pumping losses are just a few examples enabled by freely adaptable intake and exhaust valve timings. This paper presents a method to achieve the accurate tracking of load trajectories under stoichiometric conditions. A feedback controller is designed with a mixed-sensitivity H∞ synthesis method. The underlying system plant is modeled by a combination of a mean-value model of the cylinder-internal processes and a neural network to map the correlation between valve timings and cylinder charge. All experiments are conducted on a test bench with a spark-ignited engine equipped with an internally developed fully variable valve train called FlexWork. With this method, a mean absolute error of 0.07bar in indicated mean pressure and of 0.009 in air–fuel equivalence ratio is achieved for the tracking of the reference trajectory. Furthermore, a cost function dependent online optimization of the internal exhaust gas recirculation is conducted without affecting the tracking performance of the load and stoichiometry. Depending on the parametrization of the cost function, nitrogen oxide or hydrocarbon pollutants can be reduced by up to 46% or 17%, respectively.ISSN:0967-0661ISSN:1873-693

Feasibility Analysis of a Self-Reinforcing Electroadhesive Rotational Clutch 2021

Building upon recent advancements in linear electroadhesive clutch materials and performance, this paper examines the feasibility of a self-reinforcing electroadhesive rotational clutch using a simple model. The design aims to deliver improvements in applications where performance is limited by the torque-to-power and torque-to-mass ratios offered by conventional electromagnetic or magnetorheological clutches. The performance of the self-reinforcing design is related to the device's geometric parameters and hence the robustness of clutch configurations is examined by modeling the system parameters as having stochastic properties. A design example based on the clutch requirements of a gyroscopic balance assistance device is analyzed. The analysis predicts that substantial improvements in torque-to-power and torque-to-mass ratios are possible with the presented design compared to industry-leading rotational clutches

Probiotics reduce mutans streptococci counts in humans: a systematic review and meta-analysis

Objectives Systematically review the available literature regarding the caries-preventive effect of probiotics. Data, sources and study selection An electronic search was conducted in three databases (PubMed MEDLINE, ISI Web of Science and Cochrane Library) to identify all suitable studies. The outcomes had to be presented as the effect of probiotics on the incidence of caries or on the levels of mutans streptococci and/or Lactobacillus species. Human studies, written in English, with at least 15 participants, comparing a probiotic product with a placebo/no probiotic were included. Where possible, a meta-analysis was performed to obtain quantitative data. Results Since only two articles presented useful data on the caries incidence, we focused on the surrogate endpoints: mutans streptococci and/or Lactobacillus counts. The meta-analysis showed that when the probiotic and control group are compared after treatment, significantly more patients in the probiotic group had low mutans streptococci (106 CFU/ml) counts. Regarding the Lactobacillus counts, comparing the probiotic and control group at the end of the probiotic use, no significant differences could be observed, neither in low (106 CFU/ml) counts. Conclusions Within the limitations of the available data, it may be concluded that probiotics decrease the mutans streptococci counts. This suggests that probiotics could have a positive effect in the prevention of caries. Clinical relevance There is insufficient evidence that probiotics can prevent caries, but they can reduce the mutans streptococci counts