66 research outputs found

    Studies on the interaction of the carbohydrate binding module 3 from the Clostridium thermocellum CipA scaffolding protein with cellulose and paper fibres

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    The adsorption of a carbohydrate binding module (CBM3) from the Clostridium thermocellum scaffolding protein (CipA) to cellulose was analysed in this work. The effect of CBM-PEG on the drainability of E. globulus and P. sylvestris pulps and on the physical properties of the respective papersheets was also studied. The CBM binding to cellulose is often described as “irreversible”, but this classification does not fully characterize this interaction. Indeed, the results obtained demonstrate that, although the adsorption on cellulose is rather stable, CBM inter-fibre mobility may be observed. The results also showed that the CBM-PEG conjugate improves the drainability of E. globulus and P. sylvestris pulps without affecting the physical properties of the papersheets.This research was supported by Fundacao para a Ciencia e a Tecnologia under grant POCTI/BIO/45356/2002

    Fibrosis of Peritoneal Membrane, Molecular Indicators of Aging and Frailty Unveil Vulnerable Patients in Long-Term Peritoneal Dialysis

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    Funding: Sociedade Portuguesa de Nefrologia (SPN) SPN funded a project and Ana Rita Martins, MD, Nephrology fellow, for a residence at Jiménez Díaz Foundation University Hospital, Madrid under the scope of novel serum biomarkers of CKD. iNOVA4Health research program (UIDP/04462/2020) is also acknowledged to support J.M.Peritoneal membrane status, clinical data and aging-related molecules were investigated as predictors of long-term peritoneal dialysis (PD) outcomes. A 5-year prospective study was conducted with the following endpoints: (a) PD failure and time until PD failure, (b) major cardiovascular event (MACE) and time until MACE. A total of 58 incident patients with peritoneal biopsy at study baseline were included. Peritoneal membrane histomorphology and aging-related indicators were assessed before the start of PD and investigated as predictors of study endpoints. Fibrosis of the peritoneal membrane was associated with MACE occurrence and earlier MACE, but not with the patient or membrane survival. Serum α-Klotho bellow 742 pg/mL was related to the submesothelial thickness of the peritoneal membrane. This cutoff stratified the patients according to the risk of MACE and time until MACE. Uremic levels of galectin-3 were associated with PD failure and time until PD failure. This work unveils peritoneal membrane fibrosis as a window to the vulnerability of the cardiovascular system, whose mechanisms and links to biological aging need to be better investigated. Galectin-3 and α-Klotho are putative tools to tailor patient management in this home-based renal replacement therapy.publishersversionpublishe

    Adaptation-Based Programming in Haskell

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    We present an embedded DSL to support adaptation-based programming (ABP) in Haskell. ABP is an abstract model for defining adaptive values, called adaptives, which adapt in response to some associated feedback. We show how our design choices in Haskell motivate higher-level combinators and constructs and help us derive more complicated compositional adaptives. We also show an important specialization of ABP is in support of reinforcement learning constructs, which optimize adaptive values based on a programmer-specified objective function. This permits ABP users to easily define adaptive values that express uncertainty anywhere in their programs. Over repeated executions, these adaptive values adjust to more efficient ones and enable the user's programs to self optimize. The design of our DSL depends significantly on the use of type classes. We will illustrate, along with presenting our DSL, how the use of type classes can support the gradual evolution of DSLs.Comment: In Proceedings DSL 2011, arXiv:1109.032

    Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

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    Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

    International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

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    Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS
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