71 research outputs found
Diagnosis, treatment and long-term outcome of solitary fibrous tumours of the pleura
Objective: Solitary fibrous tumours of the pleura (SFTP) are rare and can histologically be differentiated into benign and malignant forms. The aim of this study is to present new cases, and discuss up-to-date preoperative examinations, the role of video-assisted thoracic surgery and long-term outcome. Methods: Between 1993 and 2006, 27 SFTPs were diagnosed (14 females, mean age±SD, 62.3±9.6 years) at our institution. Medical records were reviewed, and follow-up was obtained by repeated examinations or contact with general practitioners. Results: SFTPs were associated with symptoms in 63% of all cases. In the six patients in which positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG) was performed preoperatively, malignant lesions were all found to be positive. Complete resection was achieved by video-assisted thoracic surgery in 15 and anterolateral thoracotomy in 12 patients. Mean hospital stay was shorter for patients operated by video-assisted thoracic surgery compared to thoracotomy, 4.5 (range 3-6) versus 7.5 (range 4-25) days, respectively (pâȘ0.01). Histology revealed 17 benign and 10 malignant SFTP. Mean±SD tumour diameter of malignant SFTPs was larger than in benign forms, 11.9±7.1 versus 6.1±3.5cm, respectively (pâȘ0.01). Tumour recurrence was recognised in four patients with malignant SFTPs at a median time interval after surgery of 38 (range 6-122) months, two late deaths occurred resulting from tumour recurrences. Conclusions: SFTPs can be treated minimally invasively by video-assisted thoracic surgery with short hospital stay. Large SFTPs with increased FDG-uptake have a high likelihood for malignancy. Long-term follow-up is mandatory in malignant SFTPs because of late recurrences associated with deat
Multiancestry analysis of the HLA locus in Alzheimerâs and Parkinsonâs diseases uncovers a shared adaptive immune response mediated by HLA-DRB1*04 subtypes
Across multiancestry groups, we analyzed Human Leukocyte Antigen (HLA) associations in over 176,000 individuals with Parkinsonâs disease (PD) and Alzheimerâs disease (AD) versus controls. We demonstrate that the two diseases share the same protective association at the HLA locus. HLA-specific fine-mapping showed that hierarchical protective effects of HLA-DRB1*04 subtypes best accounted for the association, strongest with HLA-DRB1*04:04 and HLA-DRB1*04:07, and intermediary with HLA-DRB1*04:01 and HLA-DRB1*04:03. The same signal was associated with decreased neurofibrillary tangles in postmortem brains and was associated with reduced tau levels in cerebrospinal fluid and to a lower extent with increased AÎČ42. Protective HLA-DRB1*04 subtypes strongly bound the aggregation-prone tau PHF6 sequence, however only when acetylated at a lysine (K311), a common posttranslational modification central to tau aggregation. An HLA-DRB1*04-mediated adaptive immune response decreases PD and AD risks, potentially by acting against tau, offering the possibility of therapeutic avenues
Penerapan fungsi - fungsi manajemen pada perpustakaan dan arsip kota administrasi Jakarta Barat
iv, 91 hlm.; ilus.; 30 cm
Co-Forschung und Gestaltung der âSorgenden Gemeinschaft Obfeldenâ: Herausforderungen und Möglichkeiten von BĂŒrgerforschung im hybriden Setting
Immer mehr Menschen wollen so lange wie möglich ihr Seniorenleben zuhause gestalten â auch wenn sie aufgrund von Krankheit, Alter oder Behinderung auf umfassende Hilfe oder UnterstĂŒtzung angewiesen sind. Die Sorgearbeit zu Hause geht weit ĂŒber die medizinische Betreuung und Körperpflege hinaus; Haushalt und soziale Teilhabe sind zentrale Versorgungsaspekte, ohne die Versorgung zu Hause nicht funktionieren kann, respektive die LebensqualitĂ€t stark leidet. Mittels partizipativer Co-Forschung auf der Basis der Community Based Participatory Research (CBPR) richtet sich das Projekt genau darauf: Mit Bewohner/-innen und weiteren lokalen Akteursgruppen ein VerstĂ€ndnis fĂŒr Alltagsbedarfe erforschen sowie gemeinsam Handlungsempfehlungen und MaĂnahmen entwickeln. Dieser Beitrag stellt einen innovativen konzeptuellen Ansatz vor, der zwei aktuelle LösungsansĂ€tze fĂŒr die technologisch gestĂŒtzte Langzeitpflege zuhause zusammenbringt: Caring Community und Living Labs. Beide AnsĂ€tze arbeiten mit qualitativ-empirischen und Aktionsforschungs-orientierten Methoden, die im Projekt zusammengefĂŒhrt werden. Wir stellen den qualitativen Co-Forschungsprozess mit Gemeindebewohnern in einer von drei beteiligten Schweizer Gemeinden vor, der seit November 2019 mit dreijĂ€hriger Laufzeit verfolgt wird. In der Gemeinde stand die gemeinsame Formulierung einer Forschungsfrage, die Schulung von BĂŒrgerInnen zur Vorbereitung, DurchfĂŒhrung und Analyse 20 qualitativer Interviews mit Betroffenen im Zentrum. Aktuell werden die Analyseergebnisse gemeinsam verschriftlicht und ein Prozess der Entwicklung von MaĂnahmen auf der Basis der Ergebnisse wurde eingeleitet. Seit April 2020 finden die zweiwöchentlichen gemeinsamen Arbeitstreffen von hauptamtlich Forschenden und BĂŒrgerforschenden ĂŒber Videokonferenztreffen statt. In Phasen der Lockerung, wie im Herbst 2020, konnten wenige Vor-Ort-Treffen stattfinden, die teilweise mit hybrider Beteiligung durchgefĂŒhrt wurden. Die Covid-19-bedingten KontaktbeschrĂ€nkungen zeigten sich erst als groĂe HĂŒrde, doch wurden Wege gefunden, den gemeinsamen Co-Forschungsprozess weiterzuverfolgen. Die Möglichkeiten und Herausforderungen eines hybriden Settings fĂŒr eine erfolgreiche bĂŒrgerbeteiligende qualitative Forschungsarbeit werden erlĂ€utert und diskutiert
AccessibilitĂ© Ă la psychothĂ©rapie subventionnĂ©e par lâĂtat : comparaisons entre les perspectives des psychologues et des psychothĂ©rapeutes
LâamĂ©lioration de lâaccĂšs aux traitements en santĂ© mentale est depuis longtemps une prioritĂ© tant au QuĂ©bec que sur la scĂšne canadienne et internationale. Des initiatives pour accroĂźtre lâaccĂšs Ă la psychothĂ©rapie subventionnĂ©e par lâĂtat ont entre autres Ă©tĂ© mises de lâavant en Australie et au Royaume-Uni. La prĂ©sente Ă©tude a visĂ© Ă documenter comment les psychologues et les psychothĂ©rapeutes se distinguent dans leurs attitudes quant aux diffĂ©rents aspects qui dĂ©finissent ces programmes dâaccĂšs Ă la psychothĂ©rapie subventionnĂ©e par lâĂtat. Les participants (N = 1 275) ont Ă©tĂ© recrutĂ©s par courriel et invitĂ©s Ă remplir une sĂ©rie de questionnaires en ligne, lesquels portaient notamment sur : les diffĂ©rents services et modalitĂ©s de service qui devraient ĂȘtre assurĂ©s par lâĂtat ; le rĂŽle et lâautonomie des cliniciens si les services de psychothĂ©rapie devaient ĂȘtre assurĂ©s par lâĂtat ; les tarifs, les modalitĂ©s de remboursement et les conditions de travail des cliniciens. Les rĂ©sultats indiquent que les psychothĂ©rapeutes valorisent davantage la thĂ©rapie de couple et familiale, lâaide Ă lâemploi et lâorientation professionnelle que les psychologues. Quant Ă ces derniers, ils valorisent davantage lâutilisation de pratiques fondĂ©es sur des donnĂ©es probantes ainsi que le suivi en continu des rĂ©sultats du traitement, et la publication du niveau de satisfaction quant aux traitements reçus par la clientĂšle desservie. Des diffĂ©rences entre les deux groupes ont aussi Ă©tĂ© observĂ©es concernant leurs prĂ©fĂ©rences quant aux modalitĂ©s de paiement et de remboursement des services. Ces rĂ©sultats peuvent avoir des implications pour lâimplantation dâun programme de psychothĂ©rapie subventionnĂ©e par lâĂtat au QuĂ©bec.Objectives Within the Quebec context, as well as the larger Canadian and International context, increasing access to mental health care treatment has become a major health care priority (see Peachey, Hicks, & Adams, 2013). Initiatives to increase access through government-funded psychotherapy have been successfully implemented in Australia and the United Kingdom. The current study sought to document how licensed psychologists and psychotherapists in Quebec differ in their attitudes about the components of these government-funded psychotherapy programs and increasing access to psychotherapy treatment.Methods The target population for the study included both psychologists and psychotherapists whom were licensed to practice psychotherapy with the Ordre of Psychologists of Quebec. Participants (N = 1 275) were recruited by email to participate in an online questionnaire focusing on components such as the services that should be offered in a new government-funded psychotherapy model (eg., individual therapy, family therapy; including employment and debt counselling), the choice and autonomy clinicians have in their treatment interventions, the role of the referring General Practitioner (GP), the fees per psychotherapy hour, the hiring structure (e.g., in the public sector versus reimbursing private psychotherapy services), among others.Results The results indicated that psychotherapists were more in favour of including family and couple therapy, and employment/vocational counselling than psychologists. Psychologists were more in favour of using evidence-based practices as well as tracking treatment outcomes using validated measures, and publishing treatment satisfaction ratings to the public. Psychotherapists were more in favour of being paid on a session-to-session basis as opposed to be being hired on a salaried basis to offer government-funded psychotherapy.Conclusions Given that psychologists and psychotherapists differ in their training background and have historically played different roles in the health care system, it is important to understand how they differ in their perspectives on accessibility to psychotherapy. The implications for implementing government-funded psychotherapy initiatives in Quebec given the different professional perspectives of the two groups are discussed
Caring Community Living Lab: ein neuer Ansatz fĂŒr die Langzeit- Versorgung von Menschen zuhause -am Beispiel der partizipativen Erforschung und Gestaltung der «Sorgenden Gemein- schaft Obfelden»
Hintergrund/Fragestellung:
Immer mehr Menschen wollen so lange wie möglich ihr Seniorenleben zuhause gestalten â auch wenn sie aufgrund von Krankheit, Alter oder Behinderung auf umfassende Hilfe oder Un-terstĂŒtzung angewiesen sind (Otto, Zanoni, & Wepf 2015). Unter dem Leitsatz âambulant vor stationĂ€râ trĂ€gt die Schweizer Gesundheitspolitik immer mehr diesem BedĂŒrfnis Rechnung. Die Umsetzung ist allerdings noch nicht vollkommen. Die Sorgearbeit zu Hause geht weit ĂŒber die medizinische Betreuung und Körperpflege hinaus; Haushalt und soziale Teilhabe sind zentrale Versorgungsaspekte, ohne die Versorgung zu Hause nicht funktionieren kann, respektive die LebensqualitĂ€t stark leidet (WĂ€chter et al. 2015). Mittels partizipativer Co-Forschung auf der Basis der Community Based Participatory Research (CBPR) (von Unger, 2012; Wallerstein, Duran, Oetzel, & Minkler, 2018) richtet sich das Projekt genau darauf: Mit Bewohner/-innen und weiteren lokalen Akteursgruppen ein VerstĂ€ndnis fĂŒr Alltagsbedarfe erforschen sowie ge-meinsam Handlungsempfehlungen und MaĂnahmen entwickeln.
Methodik:
Wir stellen in diesem Beitrag einen innovativen konzeptuellen Ansatz vor, der zwei aktuelle Lö-sungsansĂ€tze fĂŒr die technologisch gestĂŒtzte Langzeitpflege zuhause zusammenbringt: Caring Community und Living Labs. «Caring Communities» ist ein Konzept, das Sorgearbeit als Ge-meinschaftswerk versteht (Klie 2016). Es bietet Orientierungen zur Umsetzung von Sorge-Netzwerken, die verschiedenste Akteure auf lokaler Ebene zusammenbringen. «Living Lab» bezeich-net eine Lern- und Explorationsumgebung, die Gestaltung und Evaluation digitaler Lösungen nicht nur fĂŒr Menschen, sondern mit Menschen entwickelt (Ogonowski, Jakobi, MĂŒller, & Hess, 2018); partizipative Entwicklung (Co-Design) und Testen im und am Alltag (statt nur im Labor) sind zentrale Elemente. Beide AnsĂ€tze arbeiten mit qualitativ-empirischen und Aktionsfor-schungs-orientierten Methoden, die im Projekt zusammengefĂŒhrt werden.
Erwartete Ergebnisse und Implikationen fĂŒr die Praxis:
Der Caring Community Living Lab-Ansatz wird seit November 2019 in einem dreijĂ€hrigen praxis-nahen Forschungsprojekt, in drei Deutschschweizer Gemeinden (Aare/GĂŒrbetal, Obfelden, ZĂŒ-rich-Schwamendingen) erprobt. Wir stellen in diesem Beitrag das Vorgehen zur Umsetzung sol-cher neuer Modelle auf Gemeindeebene am Beispiel der partizipativen Arbeit mit Bewohner/-innen aus Obfelden vor, erlĂ€utern das Potenzial des Ansatzes zur sozialen und technischen In-novation fĂŒr die umfassende Gesundheitsversorgung zuhause und beschreiben Risiken und HĂŒrden
Entrance flow of unfoamed and foamed HerschelâBulkley fluids
The present study investigates extrusion processing of unfoamed and foamed cocoa butter (CB) crystal-melt suspensions (CMSs) with varying crystal volume fraction ΊSFC. Capillary rheometry derived flow curves were fitted with the HerschelâBulkleyâPapanastasiou (HBP) model, and the derived yield stress to wall shear stress ratio Ï0=Ïw of CB CMSs was compared for the various ΊSFC. Foamed CB CMSs behaved fluidlike for ΊSFC 11:9% and according to a brittle porous solid for ΊSFC . 11:9%. The dimensionless entrance pressure loss nen=α as a function of dimensionless shear stress Ï* was higher for foamed compared to unfoamed CB CMSs at ΊSFC 11:9% and lower for foamed compared to unfoamed CB CMSs at ΊSFC . 11:9%. The ΊSFC dependent difference in nen=α was attributed to the crystal confinement in the die entrance flow, which is increased in the case of elastic gas bubble deformation and decreased in the case of plastic gas pore collapse. The computational fluid dynamics simulated flow of unfoamed and foamed CB CMSs through an abrupt circular 20:1 contraction with the HBP model was compared with the experimental results from quantitative entrance flow visualization (QEFV). Furthermore, the QEFV derived half center incidence angle Ξ as well as the entrance flow shear and elongational rates _ Îłef and _Ï”ef were derived and used to establish a model predicting the Bagley entrance pressure loss ÎPBag and calculate an entrance flow characteristic shear and elongational viscosities ηs ef and ηeef .ISSN:0148-605
Inkjet-based surface structuring: amplifying sweetness perception through additive manufacturing in foods
Abstract Additive manufacturing (AM) is creating new possibilities for innovative tailoring of food properties through multiscale structuring. This research investigated a high-speed inkjet-based technique aimed to modify sweetness perception by creating dot patterns on chocolate surfaces. The dots were formulated from cocoa butter with emulsified water droplets containing the sweetener thaumatin. The number and surface arrangement of dots, which ranged from uniformly distributed patterns to concentrated configurations at the sampleâs center and periphery, were varied while maintaining a constant total amount of thaumatin per sample. A sensory panel evaluated sweetness perception at three consumption time points, reporting a significant increase when thaumatin was concentrated on the surface. Specifically, an amplification of sweetness perception by up to 300% was observed, irrespective of dot pattern or consumption time, when compared to samples where thaumatin was uniformly distributed throughout the bulk. However, when thaumatin was concentrated solely at the sample center, maximum sweetness perception decreased by 24%. Conclusively, both the proximity of thaumatin to taste receptors and its spatial distribution, governed by different dot arrangements, significantly influenced taste responsiveness. These findings present a more effective technique to substantially enhance sweetness perception compared to traditional manufacturing techniques. This method concurrently allows for sensorial and visual customization of products. The implications of this study are far-reaching, opening avenues for industrially relevant AM applications, and innovative approaches to study taste formation and perception during oral processing of foods
Exploring the effects of structure and melting on sweetness in additively manufactured chocolate
In view of the health concerns associated with high sugar intake, this study investigates methods to enhance sweetness perception in chocolate without increasing its sugar content. Using additive manufacturing, chocolate structures were created from masses with varying sugar and fat compositions, where hazelnut oil served as a partial cocoa butter replacement. The study found that while variations in sugar content minimally affected the physical properties of the chocolate masses, hazelnut oil significantly modified melting behavior and consumption time. Chocolate masses with higher hazelnut oil content but similar sugar content exhibited a 24% increase in sweetness perception, likely due to accelerated tastant (i.e., sucrose) release into saliva. Multiphase structures, designated as layered, cube-in-cube, and sandwich structures, exhibited less sensory differences compared to the homogeneous control. Nonetheless, structures with hazelnut oil-rich outer layers resulted in an 11% increase in sweetness perception, even without sugar gradients. This suggests that tastant release plays a more critical role than structural complexity in modifying sweetness perception. This research highlights the efficacy of simpler multiphase structures, such as sandwich designs, which offer sensory enhancements comparable to those of more complex designs but with reduced manufacturing effort, thus providing viable options for industrial-scale production.ISSN:2045-232
- âŠ