Entrance laws of generalized Ornstein-Uhlenbeck processes and asymptotic strong Feller property for non-autonomous semigroups

Rezvani Majid N. Entrance laws of generalized Ornstein-Uhlenbeck processes and asymptotic strong Feller property for non-autonomous semigroups. Bielefeld: Universität Bielefeld; 2013

Induced Demand after Implementing the Health Reform Plan in Selected Emergency Departments Affiliated to Isfahan University of Medical Sciences: a Cross-Sectional Study

Introduction: Exactly recognizing the effect of health reform plan (HRP) in emergency departments (EDs) is crucial given the large portion of budget assigned to this plan and the effect of introducing this plan on inducing demand and the associated potentially-unbearable costs. Objective: The present study was conducted to assess the demand induced after implementing the HRP in the selected EDs of Isfahan University of Medical Sciences, Isfahan, Iran. Method: The present quantitative and descriptive study collected data related to certain emergency services, performance indicators and working hours of emergency staff using a researcher-made checklist and based on hospital records and information in the years before and after implementing the HRP in Iran, i.e. 2013 and 2015. The data collected were analyzed in SPSS-21. Results: The obtained results suggested significant increases in emergency admissions (69.97%), radiographic images (65%), clinical tests (27.27%) and specialist visits (69.95%). Significantly increases observed in the performance indicators in the ED included the mean hospitalization duration by 61.14%, the bed occupancy rate by 15.71% and the working hours of the nursing staff by 11.43% and those of emergency medicine specialists by 44.72% in the first year after implementing the HRP compared to in the year before the implementation. Conclusion: Although implementing the HRP in Iran significantly changed the performance indicators in the ED, certain infrastructure such as human resource management and the increased demand are considered the main time-consuming and costly challenges in EDs

Induced Demand after Implementing the Health Reform Plan in Selected Emergency Departments Affiliated to Isfahan University of Medical Sciences: a Cross-Sectional Study

Introduction: Exactly recognizing the effect of health reform plan (HRP) in emergency departments (EDs) is crucial given the large portion of budget assigned to this plan and the effect of introducing this plan on inducing demand and the associated potentially-unbearable costs. Objective: The present study was conducted to assess the demand induced after implementing the HRP in the selected EDs of Isfahan University of Medical Sciences, Isfahan, Iran. Method: The present quantitative and descriptive study collected data related to certain emergency services, performance indicators and working hours of emergency staff using a researcher-made checklist and based on hospital records and information in the years before and after implementing the HRP in Iran, i.e. 2013 and 2015. The data collected were analyzed in SPSS-21. Results: The obtained results suggested significant increases in emergency admissions (69.97%), radiographic images (65%), clinical tests (27.27%) and specialist visits (69.95%). Significantly increases observed in the performance indicators in the ED included the mean hospitalization duration by 61.14%, the bed occupancy rate by 15.71% and the working hours of the nursing staff by 11.43% and those of emergency medicine specialists by 44.72% in the first year after implementing the HRP compared to in the year before the implementation. Conclusion: Although implementing the HRP in Iran significantly changed the performance indicators in the ED, certain infrastructure such as human resource management and the increased demand are considered the main time-consuming and costly challenges in EDs

Is Chiari malformation a cause of systemic hypertension and sinus bradycardia? A case report and literature review

Abstract A middle aged woman, having a history of diastolic hypertension and sinus bradycardia since one year ago, was referred to our center with a sudden occipital headache after shouting. To evaluate the cause of headache the brain MRI was performed reporting a slight cerebellar tonsillar herniation of about one centimeter below the foramen magnum. After the patient was diagnosed to have type I Chiari malformation, a surgery procedure was done and the symptoms were recovered after that. Type I Chiari malformation is a disease mostly caused by congenital displacement of cerebellar tonsils through the foramen magnum. The most common symptom is headache, rarely reported with hypertension or sinus bradycardia

Pelvic Incidence Angle in Standing, Maximal Anterior and Maximal Posterior Pelvic Rotation in a Sample of Healthy Subjects

This study aimed to investigate the differences in pelvic incidence (PI) between three standing, maximal anterior and maximal posterior pelvic rotation. This cross-sectional study was done on 150 healthy subjects. Lateral spine radiography was taken in 3 different positions in the same standard radiographic protocol. Sacral slope (SS) pelvic tilt (PT), lumbar lordosis (LL) and lumbosacral junction angle were measured by two independent, experienced spine surgeons. PI was calculated as sum SS and PT. The mean of PI in standing positions was 52.6±5.1, in anterior position was 52.6±5.5 and in posterior position was 52.3±5.2 degree. The mean of PI, PT, and SS in total and between male and female subjects was not statistically significant in three different positions (P>0.05). PI in 136 subjects (90.7%) is changed when the position was changed from standing to the posterior position, by mean of 2.06 degree. When the position was changed from standing to an anterior position, the change in PI degree was observed in 126 subjects (84%) by mean of 2.12 degree. Despite the none, significant value of PI in three different positions, a large number of subjects with a change in their PI when the position was changed to anterior or posterior (90.1%) position, show that PI can be varied by pelvic rotation in healthy adult subjects

Preoperative Mechanical Bowel Evacuation Reduces Intraoperative Bleeding and Operation Time in Spinal Surgery

Study Design Randomized clinical trial. Purpose In this study, we evaluated the effect of mechanical evacuation of the bowels prior to operation on intraoperative bleeding. Overview of Literature Bleeding is the most significant complication in patients undergoing spinal surgery. Methods We randomly divided 108 individuals planned to undergo spinal surgery into two age-, sex-, and co-morbidity (especially preoperative hemoglobin [Hb])-matched groups of 54. The treatment group was administered polyethylene glycol (PEG) before the operation, whereas the control group was not. The exact amount (mL) of bleeding during operation, operative time, and approximate amount of blood transfused were recorded. The volume of bleeding and Hb level were also recorded 24 and 48 hours postoperatively. Results T-tests revealed that intraoperative bleeding, the volume of transfusion, and operative time were significantly lower in the treatment group than in the control group. Statistically significant correlations of intraoperative bleeding with age, body mass index (BMI), preoperative Hb levels, operative time, the volume of transfusion, hospitalization time, and 24- and 48-hour postoperative bleeding were observed (p =0.001, all). Repeated measures analysis of covariance after adjusting the covariate variables revealed that the volume of bleeding showed a near-significant trend in the treatment group compared with that in the control group (p =0.056). Diabetic females had the highest bleeding amount between the groups (p =0.03). Bleeding was higher in patients with higher BMI (p =0.02) and was related to operative time (p =0.001) in both the groups. Conclusions Preoperative gastrointestinal tract evacuation by PEG administration can decrease intraoperative bleeding in spinal surgeries; however, more research is imperative regarding PEG administration in surgical procedures for this purpose

Downregulation of Glutamine Synthetase, not glutaminolysis, is responsible for glutamine addiction in Notch1-driven acute lymphoblastic leukemia

The cellular receptor Notch1 is a central regulator of T-cell development, and as a consequence, Notch1 pathway appears upregulated in > 65% of the cases of T-cell acute lymphoblastic leukemia (T-ALL). However, strategies targeting Notch1 signaling render only modest results in the clinic due to treatment resistance and severe side effects. While many investigations reported the different aspects of tumor cell growth and leukemia progression controlled by Notch1, less is known regarding the modifications of cellular metabolism induced by Notch1 upregulation in T-ALL. Previously, glutaminolysis inhibition has been proposed to synergize with anti-Notch therapies in T-ALL models. In this work, we report that Notch1 upregulation in T-ALL induced a change in the metabolism of the important amino acid glutamine, preventing glutamine synthesis through the downregulation of glutamine synthetase (GS). Downregulation of GS was responsible for glutamine addiction in Notch1-driven T-ALL both in vitro and in vivo. Our results also confirmed an increase in glutaminolysis mediated by Notch1. Increased glutaminolysis resulted in the activation of the mammalian target of rapamycin complex 1 (mTORC1) pathway, a central controller of cell growth. However, glutaminolysis did not play any role in Notch1-induced glutamine addiction. Finally, the combined treatment targeting mTORC1 and limiting glutamine availability had a synergistic effect to induce apoptosis and to prevent Notch1-driven leukemia progression. Our results placed glutamine limitation and mTORC1 inhibition as a potential therapy against Notch1-driven leukemia.This work was supported by funds from the followinginstitutions: Agencia Estatal de Investigacion/Euro-pean Regional Development Fund, European Union(PGC2018-096244-B-I00, SAF2016-75442-R), Ministryof Science, Innovation and Universities of Spain,Spanish National Research Council—CSIC, InstitutNational de la Sante et de la Recherche Medicale—INSERM, Ligue Contre le Cancer—Gironde, Univer-site de Bordeaux, Fondation pour la Recherche Medi-cale, the Conseil Regional d’Aquitaine, SIRIC-BRIO,Fondation ARC and Institut Europeen de Chimie etBiologie. MJN was supported by a bourse d’excellencede la Federation Wallonie-Bruxelles (WBI) and a post-doctoral fellowship from Fondation ARC. We thankVincent Pitard (Flow Cytometry Platform, Universitede Bordeaux, France) for technical assistance in flowcytometry experiments. We thank Diana Cabrera(Metabolomics Platform, CIC bioGUNE, Spain) fortechnical assistance in metabolomics analysi

Downregulation of Glutamine Synthetase, not glutaminolysis, is responsible for glutamine addiction in Notch1-driven acute lymphoblastic leukemia

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