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Immune checkpoint inhibitor-induced colitis:A comprehensive review

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World Journal of Clinical Cases 2019年第4期7卷 405-418页

作者： Aniruddh Som Rohan Mandaliya Dana Alsaadi Maham Farshidpour aline Charabaty Nidhi Malhotra Mark C Mattar department of Internal Medicine Medstar Washington Hospital Center department of Gastroenterology MedStar Georgetown University Hospital department of Internal Medicine MedStar Georgetown University Hospital department of Internal Medicine MedStar Union Memorial Hospital and Good Samaritan Hospital department of Gastroenterology Sibley Memorial Hospital department of Gastroenterology MedStar Washington Hospital Center

Immune checkpoint inhibitors(ICIs) are monoclonal antibodies that target downregulators of the anti-cancer immune response: Cytotoxic T-lymphocyte antigen-4, programmed cell death protein-1, and its ligand programmed death-ligand *** have revolutionized the treatment of a variety of malignancies. However,many immune-related adverse events have also been described which mainly occurs as the immune system becomes less suppressed, affecting various organs including the gastrointestinal tract and causing diarrhea and colitis. The incidence of immune-mediated colitis(IMC) ranges from 1%-25% depending on the type of ICI and if used in combination. Endoscopically and histologically there is a significant overlap between IMC and inflammatory bowel disease,however more neutrophilic inflammation without chronic inflammation is usually present in IMC. Corticosteroids are recommended for grade 2 or more severe colitis while holding the immunotherapy. About one third to two thirds of patients are steroid refractory and benefit from infliximab. Recently vedolizumab has been found to be efficacious in steroid and infliximab refractory cases. While in grade 4 colitis, the immunotherapy is permanently discontinued, the decision is controversial in grade 3 colitis.

关键词： Immune checkpoint inhibitors Immune-related adverse events Cytotoxic Tlymphocyte-associated antigen 4 Programmed cell death protein 1 Programmed deathligand 1 Immune-mediated colitis

A single session of strength training changed plasma levels of resistin,but not leptin in overweight and obese men

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Sports Medicine and Health Science 2024年第4期6卷 324-330页

作者： Yago Martins Fortes Antonio Felipe Souza-Gomes Alessandro Roberto Silveira Moreira Leo Nogueira Campos Samara Silva de Moura Lucelia Scarabeli Silva Barroso Marcelo Henrique Salviano de Faria Heliana de Barros Fernandes aline Silva de Miranda Hugo Cesar Martins-Costa Ana Cristina Simoes e Silva Janaina Matos Moreira Albena Nunes-Silva Laboratory of Inflammation and Exercise Immunology Department of Physical EducationSchool of Physical EducationFederal University of Ouro PretoOuro PretoMGBrazil Postgraduate Program in Health and Nutrition Nutrition SchoolFederal University of Ouro PretoOuro PretoMGBrazil Interdisciplinary Medical Research Laboratory Faculty of MedicineFederal University of Minas GeraisBelo HorizonteMGBrazil Neurobiology Laboratory Institute of Biological SciencesFederal University of Minas GeraisBelo HorizonteMGBrazil department of Physical Education Pontifical Catholic University of Minas GeraisBrazil department of Pediatrics Faculty of MedicineFederal University of Minas Gerais(UFMG)Belo HorizonteMGBrazil

Obesity has a complex multifactorial etiology and is characterized by excessive accumulation of adipose *** adipose tissue has deleterious effects on health because it secretes large amounts of inflammatory *** calorie restriction associated with strength training may be useful in managing chronic systemic *** study aimed to evaluate the acute effect of a single strength-training session on plasma adipokine levels in sedentary,overweight,and obese young *** study included twelve men(Age:[34.95±9.77]years;Height:[174.16±3.66]centimeter[cm];Weight:[97.83±12.87]kilogram(kg);body mass index[BMI]:[32.30±4.51]kg/m2),who performed a single strength training *** strength training protocol consisted of 4 sets of 12 repetitions in the following six exercises,45°leg press,bench press,leg extension,machine row,leg curl,and shoulder *** samples were collected before,immediately after,and 1-h subsequent after strength *** plasma levels of resistin and leptin were measured.A significant decrease in resistin levels were found 1 h after the strength training session if compared to levels before the training session(pre-[before][2390±1199]picograms per milliliter[pg/mL]vs post-1 h[1-h subsequent][1523±798],6 pg/mL,p=0.0028).The plasma leptin levels did not differ at any time *** conclusion,a very well controlled single session of strength training significantly decreased the plasma levels of resistin without altering the concentration of leptin in overweight and obese *** effect,at least in part,supports the benefits of exercise by reducing the low grade inflammation and insulin resistance in obesity.

关键词： Strength training Adipose tissue Obesity Chronicinflammation Resistin Leptin

Healthcare bioethics: a new proposal of ethics for clinical practice

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History & Philosophy of Medicine 2023年第2期5卷 20-25页

作者： aline Albuquerque Cintia Tanure Post Graduate Programme of Bioethics University of BrasíliaCampus Universitário Darcy Ribeiro 70910-900Brazil Post Graduate Programme of Nursing University of BrazilCampus Universitário Darcy Ribeiro 70910-900Brazil

The expression“patient revolution”is the social,educational,cultural,and political movement initiated at the end of the twentieth century and beginning of the twenty-first century,which sustains the protagonism of the patients in their care as the primary decision maker and holder of human *** patient revolution comprises varied approaches and references,such as Patient-Centered Care,Shared decision-Making,Patient Participation,and Patients’Rights,which combine to uphold that the patient is a moral agent and anchor healthcare in the biopsychosocial *** this sense,this movement is a new proposal of ethics for clinical *** theoretical research primary goal is to develop theoretical contributions that support this new Bioethics dimension,emphasizing the context in healthcare that calls for new ethics in clinical practice,characterized as a patient revolution *** concluded that the patient revolution had driven a new paradigm in healthcare based on Patient-Centricity,SDM,and Patients’*** this critical change in the health sphere,the patient revolution appears to have reverberated in clinical ***,theoretical contributions must be developed for new ethics in the clinic,a task undertaken in this article through the proposal of Healthcare Bioethics as an adequate frame of reference to be adopted at all levels of clinical ***,it is concluded that having Bioethics Healthcare as a beacon of ethics in clinical encounters can contribute to the quality of care and its ethical provision,confronting practices that violate Patients’*** is imperative to change paternalistic theoretical frameworks that mitigate the Patients’Right to participate in every decision regarding their *** with the adoption of new approaches and an insight into the patient’s role in clinical interaction can a new culture in Patient-Centered healthcare take shape.

关键词： patient bioethics healthcare Patients’Rights

Salvage anastomosis in free PAP-flap breast reconstruction:What about free flap neovascularization?

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Chinese Journal of Plastic and Reconstructive Surgery 2023年第4期5卷 178-181页

作者： Michael Hepp aline Berners Christine deconinck Genevieve Pirson Maxime Servaes Philippe Fosseprez department of Plastic Reconstructive and Aesthetic SurgeryCHU UCL NamurNamur 5000Belgium

Since the emergence of microsurgery in reconstructive surgery, free flaps have become a key tool in the management of patients with breast cancer. One such flap is the profunda artery perforator(PAP) flap. To date,there is no scientific consensus on whether voluminous free flaps remain dependent on their vascular pedicle throughout their lifespan. Therefore, the pedicle should always be carefully protected during revision *** this article, we review the case of a middle-aged woman who suffered a pedicle transection needing reanastomosis during revision surgery six months after free-flap breast reconstruction. A 52-year-old woman who noticed a firm nodule in her right breast and armpit was referred to our department for surgical management. The Caucasian woman presented with no significant medical history or symptoms at the first consultation. Ultrasound-guided biopsy confirmed an invasive grade Ⅲ lobular carcinoma. Following staging,the patient underwent neoadjuvant chemotherapy before a right mastectomy with a complete homolateral axillary lymph node dissection and postoperative radiotherapy. One year after completing radiotherapy, free flap reconstruction with a PAP flap was performed, and six months later, revision surgery was required to enhance the volume of the reconstructed breast with a tissue expander and later an implant. Unfortunately,pedicle transection occurred during revision surgery, causing complete devascularization of the flap, which was confirmed by intraoperative Indocyanine Green imaging. The authors elected to perform salvage reanastomosis during the surgery. In keeping with the author’s 23-year experience with free flaps, the vascular pedicle should always be preserved in voluminous free flaps, as neovascularization alone may not ensure whole flap survival. The authors suggest always attempting re-anastomosis if vessels are compromised during revision surgery.

关键词： Free flap Autonomy Vascular pedicle Revascularization PAP flap Microsurgery

A Neural Based Modeling Approach for Drying Kinetics Analysis of Mint Branches and Their Fractions (Leaves and Stems)

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Advances in Chemical Engineering and Science 2017年第2期7卷 154-174页

作者： aline de Holanda Rosanova Gustavo Dias Maia Fábio Bentes Freire Maria do Carmo Ferreira Graduate Program of Chemical Engineering Federal University of S&atilde o Carlos S&atilde o Carlos Brazil Chemical Engineering department Federal University of S&atilde o Carlos S&atilde o Carlos Brazil

This work is aimed at investigating regular mint (Mentha × villosa) drying behavior and assessing how the heterogeneous composition of plants affects their drying kinetics. Drying kinetics and sorption isotherms were evaluated for whole branches and their fractions (leaves and stems). Stems and leaves were characterized by measurement of dimensions, apparent density and initial moisture content. The moisture sorption isotherms were obtained under temperatures of 30°C, 40°C and 50°C for branches, stems and leaves and the data were fitted to the GAB model. Mint branches and their fractions were oven dried at temperatures from 40°C to 70°C?and were obtained kinetic curves for each part. Water sorption patterns were similar for leaves and stems and the GAB model described well the sorption behavior of both materials. At a constant temperature, the drying rates were higher for leaves in comparison to stems and the differences increased as the temperature was raised. Therefore, depending on drying conditions, the moisture distribution in dried branches might be significantly different. Since the leaves constitute the major fraction in branches, the drying rates of branches were closer to those of leaves. The kinetic curves were fitted to a diffusion model based on an analytical solution of Fick’s second diffusion law and to an empirical model based on artificial neural network (ANN). The results showed that the model based on the ANN predicted the drying kinetics of the different parts better than the diffusive model. A single network was built to describe the kinetic behavior of branches and fractions in the whole range of temperatures investigated. The diffusive model based on fitting effective diffusivity did not provide good predictions of moisture content, probably because neither the dependence of effective diffusivity on the moisture content nor the heterogeneity and shrinking of static beds were considered.

关键词： Aromatic Herbs Regular Mint Branches Stems Sorption Isotherms Oven Drying Artificial Neural Network

Identification of the Profile of Vulnerable Population to Elaborate Efficient Employment Strategy:Proposition of a Quantitative-creative Approach

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Journal of Management Science & Engineering Research 2021年第2期4卷 16-27页

作者： Jênifer Ribeiro Dona Istefani Carisio de Paula Alceu Terra do Nascimento aline Cafruni Gularte Federal University of Rio Grande do Sul Brazil Intelligence core for projects and systems research group Brazil Mãos Verdes Work Cooperative Brazil

Brazilian public managers have been structuring and updating policies to support workers’employment and income ***,when the vulnerable individual has social,emotional,or technical limitations,success in this operation becomes *** research aim was to propose a methodology to identify profiles in vulnerable populations,viewing to promote the efficient elaboration of employment and income *** unit of analysis was vulnerable population of waste pickers,in a large city from South Brazil,in the scope of a municipal program named"All of us are Porto Alegre".A literature review allowed the identification of tools from marketing,economy and design adequate to profile analysis.A workshop with social educators responsible for giving support to the *** from workshop and the literature allowed the proposition of a methodology including cluster analysis and the creative tool named *** methodological approach suggests it is adequate in confirming the differences in *** theoretical contribution lies in the use of quantitative-creativity tools to support *** practical contribution is to provide consistent information for governmental decision-making at the labor access market.

关键词： Labor policy Vulnerable population Persona Cluster analysis

Analysing the impact of migration on HIV/AIDS cases using epidemiological modelling to guide policy makers

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Infectious Disease Modelling 2022年第1期7卷 252-261页

作者： Ofosuhene O.Apenteng Prince P.Osei Noor Azina Ismail aline Chiabai Division for Global Surveillance Research Group for Genomic EpidemiologyNational Food InstituteTechnical University of DenmarkKongens LyngbyDenmark School of Mathematics and Statistics Carleton UniversityCanada department of Statistics University of HaifaIsrael department of Applied Statistics Faculty of Economics and AdministrationUniversity of MalayaKuala LumpurMalaysia Basque Centre for Climate Change(BC3) LeioaSpain

In this paper,we present the impact of migration on the spread of HIV and AIDS cases.A simple model for HIV and AIDS that incorporates migration and addresses its contributions to the spread of HIV and AIDS cases was *** model was calibrated to HIV and AIDS incidence data from *** explore the use of Markov chain Monte Carlo(MCMC)simulation method to estimate uncertainty in all the unknown parameters incorporated in our proposed *** the migrant population,1.5572e-01 were susceptible to HIV transmission,which constituted 67,801 migrants.A proportion of migrants,6.3773e-04,were estimated to be HIV infected,constituting 278 *** were 72(per 10,000)migrants estimated to have had AIDS,representing a proportion of *** result suggests that the disease-free steady state was unstable since the estimated basic reproduction number R0 was 2.0906 and 2.3322 for the models without and with migration,*** is not a good indicator from the public health point of view,as the aim is to stabilize the epidemic at the disease-free *** advantage of introduction of migration to the simple model validated the true R0 and the transmission rate b associated with HIV and AIDS epidemic disease in *** also indicates an approximately 12 percentage points increase in the rate of HIV infection with migration.

关键词： Migration Mathematical transmission modeling HIV/AIDS Parameter estimation Basic reproduction number

Hepatitis C virus: Promising discoveries and new treatments

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World Journal of Gastroenterology 2016年第28期22卷 6393-6401页

作者： Juliana Cristina Santiago Bastos Marina Aiello Padilla Leonardo Cardia Caserta Noelle Miotto aline Gonzalez Vigani Clarice Weis Arns Laboratory of Virology Institute of Biology State University of Campinas - UNICAMP Internal Medicine department Infectious Diseases division FCM-UNICAMP

despite advances in therapy, hepatitis C virus(HCV) infection remains an important global health issue. It is estimated that a significant part of the world population is chronically infected with the virus, and many of those affected may develop cirrhosis or liver cancer. The virus shows considerable variability, a characteristic that directly interferes with disease treatment. The response to treatment varies according to HCV genotype and subtype. The continuous generation of variants(quasispecies) allows the virus to escape control by antivirals. Historically, the combination of ribavirin and interferon therapy has represented the only treatment option for the disease. Currently, several new treatment options are emerging and are available to a large part of the affected population. In addition, the search for new substances with antiviral activity against HCV continues, promising future improvements in treatment. Researchers should consider the mutation capacity of the virus and the other variables that affect treatment success.

关键词： Hepatitis C infection Hepatitis C virus Treatments Antiviral research

Physical Accessibility for Disabled People: Analysis of Toilet Facilities in Primary Health Care Units

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Open Journal of Nursing 2016年第11期6卷 948-957页

作者： aline Cruz Esmeraldo Áfio Luciana Vieira de Carvalho Juliana Freitas Marques Paula Marciana Pinheiro de Oliveira Paulo Cesar de Almeida Lorita Marlena Freitag Pagliuca Nursing department Federal University of Ceará (UFC) Fortaleza Brazil University of International Integration of the Afro-Brazilian Lusophony (UNILAB) Reden&ccedil&atildeo Brazil State University of Ceará (UECE) Fortaleza Brazil

Background: Accessibility enables the effective participation of disabled persons in public and private areas and the use of urban equipment and street furniture. Objective: This study aimed to analyze the physical accessibility of toilet facilities in urban and rural primary health care units. Methods: It was a quantitative descriptive study conducted in 157 Primary Health Care Units of 16 municipalities in the Baturité Massif region, Ceará, Brazil. The study took place from August 2014 to May 2015, with a checklist type form, designed from the Technical Standard 9050 of the Brazilian National Standards Organization, specifying the ideal access conditions established by law to allow mobility of persons with physical disabilities. Data were processed through the Statistical Package for the Social Sciences software and organized into tables. Results: Toilets designed for physically disabled people were accessible as the location and signs (59.9%), identified with symbols for males and females (57.3%);however, the doorway width was smaller than needed to accommodate a wheelchair (77.7%). Inside the bathroom, only the forward approach was possible (59.9%). Grab bars positioned on the side and rear walls were inadequate or nonexistent (67.6%);toilet seats (91.1%) and toilet paper dispensers (96.2%) were mostly in inaccessible heights;flush controls in appropriate height (59.2%) and activated by light pressure (58%). Sinks without pedestal (51%), but higher than recommended (80.3%) and without single handle faucets (95.6%). It was verified that the toilets of basic health units located in urban areas had better accessibility conditions compared to those in rural areas. Conclusion: Results showed that the analyzed units presented physical inaccessibility in some toilet facilities, making it difficult or even impossible the accessibility for the disabled. The inclusion of accessibility features in health services for this clientele provides equal opportunities and social i

关键词： Health Services Accessibility Disabled Persons Toilet Facilities