The Impact of Permutable Configurations on Distributed Systems

In recent years, much research has been devoted to the study of DNS; however, few have visualized the structured unification of linked lists and sen- sor networks. After years of structured research into agents, we prove the investigation of agents, which embodies the confusing principles of algorithms. Here we present a heuristic for ambimorphic configurations (RHUS), which we use to dis- prove that replication and thin clients are often in-compatible

The continuum limit of the quark mass step scaling function in quenched lattice QCD

The renormalisation group running of the quark mass is determined non-perturbatively for a large range of scales, by computing the step scaling function in the Schroedinger Functional formalism of quenched lattice QCD both with and without O(a) improvement. A one-loop perturbative calculation of the discretisation effects has been carried out for both the Wilson and the Clover-improved actions and for a large number of lattice resolutions. The non-perturbative computation yields continuum results which are regularisation independent, thus providing convincing evidence for the uniqueness of the continuum limit. As a byproduct, the ratio of the renormalisation group invariant quark mass to the quark mass, renormalised at a hadronic scale, is obtained with very high accuracy.Comment: 23 pages, 3 figures; minor changes, references adde

Twisted-mass lattice QCD with mass non-degenerate quarks

The maximally twisted lattice QCD action of an $SU_f(2)$ doublet of mass degenerate Wilson quarks gives rise to a real positive fermion determinant and it is invariant under the product of standard parity times the change of sign of the coefficient of the Wilson term. The existence of this spurionic symmetry implies that O($a$) improvement is either automatic or achieved through simple linear combinations of quantities taken with opposite external three-momenta. We show that in the case of maximal twist all these nice results can be extended to the more interesting case of a mass non-degenerate quark pair.Comment: 10 pages (due to different LateX style), Latex file, based on a talk presented by G.C. Rossi at LHP2003 - Cairns. Reasons for replacement: Correction of the transformation properties of energies under r --> -r. Minor changes in Appendix

Efficacy and safety of atacicept for prevention of flares in patients with moderate-to-severe systemic lupus erythematosus (SLE): 52-week data (APRIL-SLE randomised trial)

OBJECTIVES: Despite advances in systemic lupus erythematosus (SLE) treatment, many patients suffer from the disease and side effects. Atacicept is a fusion protein that blocks B-lymphocyte stimulator and a proliferation-inducing ligand, which are increased in patients with SLE. METHODS: In this double-blind, placebo-controlled study, patients with moderate-to-severe SLE were randomised to atacicept 75 mg or atacicept 150 mg administered subcutaneously, or placebo twice-weekly for 4 weeks, then weekly for 48 weeks. Primary and secondary efficacy measures were the proportion of patients experiencing at least one flare of British Isles Lupus Assessment Group A or B, and time to first flare, respectively. RESULTS: Enrolment in the atacicept 150 mg arm was discontinued prematurely due to two deaths. In the intention-to-treat population (n=461), there was no difference in flare rates or time to first flare between atacicept 75 mg and placebo. Analysis of patients treated with atacicept 150 mg suggested beneficial effect versus placebo in flare rates (OR: 0.48, p=0.002) and time to first flare (HR: 0.56, p=0.009). Both atacicept doses were associated with reductions in total Ig levels and anti-dsDNA antibodies, and increases in C3 and C4 levels. Most treatment-emergent adverse events were mild or moderate. CONCLUSIONS: There was no difference between atacicept 75 mg and placebo for flare rate or time to first flare. Analysis of atacicept 150 mg suggested benefit. TRIAL REGISTRATION NUMBER: EudraCT: 2007-003698-13; NCT00624338

Post Hoc Analysis of the Phase II/III APRIL-SLE Study::Association Between Response to Atacicept and Serum Biomarkers including BLyS and APRIL

ObjectiveTo assess the relationship between treatment response, baseline biomarker levels, and atacicept exposure in patients with systemic lupus erythematosus (SLE) in the phase II/III APRIL-SLE study.MethodsWe performed a post hoc analysis of patients who received placebo, atacicept 75 mg, or atacicept 150 mg in a randomized, controlled, 52-week trial. Serum levels of BlyS and APRIL were measured at baseline, and serum levels of Ig and the numbers of naive B cells and plasma cells were measured at baseline and during treatment. Atacicept exposure was determined by assessment of the serum trough concentrations throughout the 52-week trial period. Associations between these parameters, treatment response (reduction in British Isles Lupus Assessment Group A or B flare), and infection rates were explored.ResultsRecurrent high baseline levels of both BLyS (≥1.6 ng/ml) and APRIL (≥2.2 ng/ml) correlated with a greater treatment response (flare rate 75.7% with placebo, and 50.0% and 32.0% with atacicept 75 mg and atacicept 150 mg, respectively) compared with lower baseline levels of both. Increased atacicept exposure correlated with reduced flare rates (60.5% with placebo; 63.4%, 61.0%, 48.8%, and 29.3% in the 4 quartiles, from lowest to highest atacicept exposure). Greater pharmacodynamic responses (reduced Ig levels and naive B cell and plasma cell numbers) were associated with greater reductions in the flare rate. Infection rates were similar regardless of biomarker levels at baseline or at the time of atacicept exposure.ConclusionThese post hoc analyses demonstrate a dose-response relationship between atacicept concentrations, reduced Ig levels, and reduced flare rates and suggest that baseline biomarkers such as elevated serum levels of BLyS and APRIL may help to identify the patients who are most likely to benefit from atacicept treatment

Conhecimento de familiares e cuidadores sobre cuidados paliativos: revisão integrativa de literatura: Family and caregiver’s knowledge about palliative care: integrative literature review

Cuidados Paliativos são abordagens promovida por uma equipe interprofissional, que visam tratar e prevenir o sofrimento dos pacientes com doenças ameaçadoras da vida, promovendo conforto para eles e seus familiares. Portanto, devido a fatores culturais, políticos dentre outros, o entendimento de familiares sobre o tema é tênue. Dessarte, objetivou-se identificar o conhecimento de familiares e cuidadores sobre CP em base de dados científicas da literatura nacional e internacional. Estudo de Revisão Integrativa de Literatura com busca de artigos nas bases de dados online BVS, PubMed e SciELO, abrangendo artigos publicados entre janeiro de 2015 a dezembro de 2020. Adotados como critérios de inclusão: artigos gratuitos, em um dos idiomas: Português, Inglês e Espanhol com os descritores:  Cuidados Paliativos, Percepção, Família, Cuidadores e Conhecimento e uso do operador Booleano (AND). Utilizou-se a estratégia PICO (patient, intervention, comparison, outcomes), além do guideline PRISMA (2020). Foram encontrados 1358 artigos nas bases de dados supracitadas sendo 83 selecionados para análise e cinco para a revisão. Dos artigos selecionados três provêm de pesquisas realizadas no Brasil, um no México e um na Alemanha. Analisando-se as semelhanças e diferenças entre os resultados, surgiram três categoriais temáticas: 1) Falta de políticas públicas; 2) Má divulgação da modalidade de cuidado; 3) Desconhecimento dos profissionais da saúde e da comunidade. O conhecimento de CP entre familiares e cuidadores ainda são insuficientes e refletem a fragilidade na educação de profissionais de saúde e a conturbada comunicação equipe-família-cuidadores

Lymphatic vessels in human adipose tissue

Despite being considered present in most vascularised tissues, lymphatic vessels have not been properly shown in human adipose tissue (AT). Our goal in this study is to investigate an unanswered question in AT biology, regarding lymphatic network presence in tissue parenchyma. Using human subcutaneous (S-) and visceral (V-) AT samples with whole mount staining for lymphatic specific markers and three-dimensional imaging, we showed lymphatic capillaries and larger lymphatic vessels in the human VAT. Conversely, in the human SAT, microcirculatory lymphatic vascular structures were rarely detected and no initial lymphatics were found

Síndrome de Herlyn Werner Wunderlich: um relato de caso

A síndrome de Herlyn Werner Wunderlich é uma má formação congênita rara dos dutos mullerianos, caracterizada por útero didelfo, hemivagina obstruída e agenesia renal unilateral, com diagnóstico mais comum após a menarca. Nesse artigo demonstraremos um de uma paciente de 16 anos, admitida em um pronto socorro ginecológico de Vitória-ES referindo dor em fossa ilíaca esquerda. Ao exame físico, apresentava abdome doloroso à palpação supra púbica e em fossa ilíaca esquerda com sinais de defesa. Paciente possuía ultrassonografia de fora do serviço evidenciando massa anexial a esclarecer e moderada quantidade de líquido livre em cavidade abdominal. Portanto, foi realizada uma laparotomia exploradora, que ao inventário da cavidade visualizou-se útero didelfo, com trompa esquerda aumentada de tamanho e distorcida anatomicamente devido a hematossalpinge, sendo então realizada salpingectomia à esquerda. Devido aos achados cirúrgicos foi levantada a hipótese de Síndrome de Herlyn-Werner-Wunderlich e solicitado tomografia computadorizada de abdome que apresentou agenesia renal esquerda, e ultrassonografia que demonstrou aumento do volume uterino devido a hematométrio. A paciente foi encaminhada para cirurgia de septoplastia vaginal total à esquerda na qual identificou-se loja de abscesso em parede vaginal antero-lateral esquerda e posterior identificação de vagina esquerda comunicando com colo uterino esquerdo. Evoluiu com piora clínica e laboratorial, mesmo após tratamento com antibioticoterapia, sendo necessária nova laparotomia exploradora afim de identificar o foco infeccioso, durante o procedimento visualizado abscesso ovariano esquerdo, sendo realizado, portanto, ooforectomia à esquerda. Paciente evoluiu com melhora clínica após procedimento cirúrgico e antibioticoterapia de amplo espectro recebendo alta médica em junho de 2020