192 research outputs found

    Weak factorization systems and fibrewise regular injectivity for actions of pomonoids on posets

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    Let S be a pomonoid. In this paper, Pos-S, the category of S-posets and S-poset maps, is considered. One of the main aims of this paper is to draw attention to the notion of weak factorization systems in Pos-S. We show that if S is a pogroup, or the identity element of S is the bottom (or top) element, then (DU,SplitEpi) is a weak factorization system in Pos-S, where DU and SplitEpi are the class of du-closed embedding S-poset maps and the class of all split S-poset epimorphisms, respectively. Among other things, we use a fibrewise notion of complete posets in the category Pos-S/B under a particular case that B has trivial action. We show that every regular injective object in Pos-S/B is topological functor. Finally, we characterize them under a special case, where S is a pogroup

    Comparison between prothrombin complex concentrate (PCC) and fresh frozen plasma (FFP) for the urgent reversal of warfarin in patients with mechanical heart valves in a tertiary care cardiac center

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    Fresh frozen plasma (FFP) and prothrombin complex concentrate (PCC) reverse oral anticoagulants such as Warfarin. We compared the standard dosage of FFP and PCC in terms of efficacy and safety for patients with mechanical heart valves undergoing interventional procedures while receiving Warfarin. Fifty patients were randomized (25 for each group) with mechanical heart valves international normalized ratio (INR) >2.5. FFP dosage was administered based on body weight (10-15 mL/Kg), while PCC dosage was administered based on both body weight and target INR. INR measurements were obtained at different time after PCC and FFP infusion. The mean ± SD of INR pre treatment was not significantly different between the PCC and FFP groups. However, over a 48-hour period following the administration of PCC and FFP, 76% of the patients in the PCC group and only 20% of the patients in the FFP group reached the INR target. Five (20%) patients in the PCC group received an additional dose of PCC, whereas 17 (68%) patients in the FFP group received a further dose of FFP (P=0.001). There was no significant difference between the two groups in Hb and Hct before and during a 48-hour period after PCC and FFP infusion. As regards safety monitoring and adverse drug reaction screening in the FFP group, the INR was high (INR > 2.5) in 86% of the patients. There was no report of hemorrhage in both groups. PCC reverses anticoagulation both effectively and safely while having the advantage of obviating the need to extra doses. © 2015 by School of Pharmacy Shaheed Beheshti University of Medical Sciences and Health Services

    Evaluation of time in therapeutic range (TTR) in patients with non-valvular atrial fibrillation receiving treatment with warfarin in Tehran, Iran: A cross-sectional study

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    Introduction: Anticoagulant control is assessed by Time in Therapeutic Range (TTR). For a given patient, TTR is defined as the duration of time in which the patient�s International Normalized Ratio (INR) values were within a desired range. Aim: To assess TTR in patients receiving treatment with warfarin for non-valvular atrial fibrillation at a referral center for cardiovascular diseases in Tehran, Iran. Materials and Method: Over 6 months, we enrolled eligible patients presenting to Shaheed Rajaie Hospital in Tehran for regular INR testing. Demographic data, medical history, and current medications were determined for all participants. TTR was assessed by the Rosendaal method. Results: A total of 470 patients (mean age 58.0±14.2 years, 60.2 women) underwent 1450 INR measurements. The mean TTR was calculated as 54.9±11.9. Of the sample patients, 37.3 were in the good control category (TTR > 70), 24.6 were in the intermediate category (50 < TTR < 70), and 38.1 were in the poor control category (TTR < 50). The number of current medications above four was a significant predictor of poor control (OR = 2.06; 95 CI, 1.87, 2.23). The mean TTR of the studied patients (54.9) was below the good control range. Conclusion: The quality of anticoagulant therapy with warfarin in Iranian patients is poorer than that reported in European countries. Based on these results, research considering the causes of poor TTR among Iranian patients is recommended. © 2016, Journal of Clinical and Diagnostic Research. All rights reserved

    Effects of Dexmedetomidine on surgical stress responses at patients under CABG

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    Cardiopulmonary bypass (CPB) surgery with extracorporeal circulation produce changes in the immune system and plasma levels of inflammatory cytokines. we hypothesize that Dexmedetomidine as an adjuvant , modulates the inflammatory response after CABG. In a prospective, randomized, blind study, 31 patients were assigned to Dexmedetomidine (Dex) group and compared with control group of 30 patients. Dex was administered at a loading dose of 0.5 μg/kg for 10 min , followed by a continuous infusion of 0.5 μg/kg per hour until the completion of CABG with CPB . The endpoints used to assess inflammatory responses to mini - CPB were plasma tumor necrosis factor (TNF) - � , interleukin (IL - 6 ) and interleukin ( IL - 10) levels. The inflammatory markers (IL - 6 , IL - 10 , TNF - � ) were determined after Dex administration , before CPB and 24 hours after admission to ICU. Biochemical factors including glucose , creatinine , lactate , BUN, AST , ALT , LDH were determined before CPB, immediately after entering the ICU , 24 hr , 48 hr and 72 hr post admission to ICU. Hemodynamic variables were also determined. Dex group was associated with a significant reduction in urea and creatinine. There were no significant differences in glucose, lactate, liver enzymes, LDH , IL - 6, IL - 10 and hemodynamic variables. In contrast, the surgery - induced increase in TNF - � levels in the Dex group was significantly higher compared with the control group

    A phase II trial of CHOP chemotherapy followed by yttrium 90 ibritumomab tiuxetan (Zevalin) for previously untreated elderly diffuse large B-cell lymphoma patients

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    Background: A prospective, single-arm, open-label, nonrandomized phase II combination chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) plus radioimmunotherapy trial was conducted to evaluate the efficacy and safety in untreated elderly diffuse large B-cell lymphoma (DLBCL) patients. Patients and methods: From February 2005 to April 2006, in our institute we treated 20 eligible elderly (age 6560 years) patients with previously untreated DLBCL using a novel regimen consisting of six cycles of CHOP chemotherapy followed 6-10 weeks later by 90Y ibritumomab tiuxetan. Results: The overall response rate to the entire treatment regimen was 100%, including 95% complete remission (CR) and 5% partial remission. Four (80%) of the five patients who achieved less than a CR with CHOP improved their remission status after radioimmunotherapy. With a median follow-up of 15 months, the 2-year progression-free survival was estimated to be 75%, with a 2-year overall survival of 95%. The 90Y ibritumomab tiuxetan toxicity included grade 653 hematologic toxicity in 12 of 20 patients; the most common grade 653 toxic effects were neutropenia (12 patients) and thrombocytopenia (7 patients). Transfusions of red blood cells and/or platelets were given to one patient. Conclusion: This study has established the feasibility, tolerability, and efficacy of this regimen for elderly patients with DLBCL

    Variational Methods for Biomolecular Modeling

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    Structure, function and dynamics of many biomolecular systems can be characterized by the energetic variational principle and the corresponding systems of partial differential equations (PDEs). This principle allows us to focus on the identification of essential energetic components, the optimal parametrization of energies, and the efficient computational implementation of energy variation or minimization. Given the fact that complex biomolecular systems are structurally non-uniform and their interactions occur through contact interfaces, their free energies are associated with various interfaces as well, such as solute-solvent interface, molecular binding interface, lipid domain interface, and membrane surfaces. This fact motivates the inclusion of interface geometry, particular its curvatures, to the parametrization of free energies. Applications of such interface geometry based energetic variational principles are illustrated through three concrete topics: the multiscale modeling of biomolecular electrostatics and solvation that includes the curvature energy of the molecular surface, the formation of microdomains on lipid membrane due to the geometric and molecular mechanics at the lipid interface, and the mean curvature driven protein localization on membrane surfaces. By further implicitly representing the interface using a phase field function over the entire domain, one can simulate the dynamics of the interface and the corresponding energy variation by evolving the phase field function, achieving significant reduction of the number of degrees of freedom and computational complexity. Strategies for improving the efficiency of computational implementations and for extending applications to coarse-graining or multiscale molecular simulations are outlined.Comment: 36 page

    Localization and density of phoretic deutonymphs of the mite Uropoda orbicularis (Parasitiformes : Mesostigmata) on Aphodius beetles (Aphodiidae) affect pedicel length

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    The phoretic stage of Uropodina mites is a deutonymph with developed morphological adaptations for dispersal by insects. Phoretic deutonymphs are able to produce a pedicel, a stalk-like temporary attachment structure that connects the mite with the carrier. The aim of our study was to determine whether localization and density of phoretic deutonymphs on the carrier affect pedicel length. The study was conducted on a common phoretic mite-Uropoda orbicularis (Uropodina) and two aphodiid beetles-Aphodius prodromus and Aphodius distinctus. Our results show that pedicel length is influenced by the localization of deutonymphs on the body of the carrier. The longest pedicels are produced by deutonymphs attached to the upper part of elytra, whereas deutonymphs attached to femora and trochanters of the third pair of legs and the apex of elytra construct the shortest pedicels. In general, deutonymphs attached to more exposed parts of the carrier produce longer pedicels, whereas shorter pedicels are produced when deutonymphs are fixed to non-exposed parts of the carrier. A second factor influencing pedicel length is the density of attached deutonymphs. Mean pedicel length and deutonymph densities were highly correlated: higher deutonymph density leads to the formation of longer pedicels. The cause for this correlation is discussed, and we conclude that pedicel length variability can increase successful dispersal

    Organoids and organ chips in ophthalmology

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    Recent advances have driven the development of stem cell-derived, self-organizing, three-dimensional miniature organs, termed organoids, which mimic different eye tissues including the retina, cornea, and lens. Organoids and engineered microfluidic organ-on-chips (organ chips) are transformative technologies that show promise in simulating the architectural and functional complexity of native organs. Accordingly, they enable exploration of facets of human disease and development not accurately recapitulated by animal models. Together, these technologies will increase our understanding of the basic physiology of different eye structures, enable

    18F-fluoro-deoxy-glucose focal uptake in very small pulmonary nodules: fact or artifact? Case reports

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    ABSTRACT: BACKGROUND: F-fluoro-deoxy-glucose (18F-FDG) positron emission tomography integrated/combined with computed tomography (PET-CT) provides the best diagnostic results in the metabolic characterization of undetermined solid pulmonary nodules. The diagnostic performance of 18F-FDG is similar for nodules measuring at least 1 cm and for larger masses, but few data exist for nodules smaller than 1 cm. CASE PRESENTATION: We report five cases of oncologic patients showing focal lung 18F-FDG uptake on PET-CT in nodules smaller than 1 cm. We also discuss the most common causes of 18F-FDG false-positive and false-negative results in the pulmonary parenchyma. In patient 1, contrast-enhanced CT performed 10 days before PET-CT did not show any abnormality in the site of uptake; in patient 2, high-resolution CT performed 1 month after PET showed a bronchiole filled with dense material interpreted as a mucoid impaction; in patient 3, contrast-enhanced CT performed 15 days before PET-CT did not identify any nodules; in patients 4 and 5, contrast-enhanced CT revealed a nodule smaller than 1 cm which could not be characterized. The 18F-FDG uptake at follow-up confirmed the malignant nature of pulmonary nodules smaller than 1 cm which were undetectable, misinterpreted, not recognized or undetermined at contrast-enhanced CT. CONCLUSION: In all five oncologic patients, 18F-FDG was able to metabolically characterize as malignant those nodules smaller than 1 cm, underlining that: 18F-FDG uptake is not only a function of tumor size but it is strongly related to the tumor biology; functional alterations may precede morphologic abnormalities. In the oncologic population, especially in higher-risk patients, PET can be performed even when the nodules are smaller than 1 cm, because it might give an earlier characterization and, sometimes, could guide in the identification of alterations missed on CT
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