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Assessment of clinical dehydration using point of care ultrasound for pediatric patients in rural Panama

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World Journal of Emergency Medicine 2019年第1期10卷 46-50页

作者： Genevieve Mazza carina Mireles Romo Marlene Torres Ali Duffens Annasha Vyas Katherine Moran Joshua Livingston Savannah Gonzales Shadi Lahham Inna Shniter Maxwell Thompson John Christian fox School of Medicine University of California Irvine Department of Emergency Medicine University of California Irvine

BACKGROUND: Dehydration and its associated symptoms are among the most common chief complaints of children in rural Panama. Previous studies have shown that intravascular volume correlates to the ratio of the diameters of the inferior vena cava(IVC) to the aorta(Ao). Our study aims to determine if medical students can detect pediatric dehydration using ultrasound on patients in rural Panama. METHODS: This was a prospective, observational study conducted in the Bocas del Toro region of rural Panama. Children between the ages of 1 to 15 years presenting with diarrhea, vomiting, or parasitic infection were enrolled in the study. Ultrasound measurements of the diameters of the IVC and abdominal aorta were taken to assess for dehydration. RESULTS: A total of 59 patients were enrolled in this study. Twenty-four patients were clinically diagnosed with dehydration and 35 were classified to have normal hydration status. Of the 24 patients with dehydration, half(n=12) of these patients had an IVC/Ao ratio below the American threshold of 0.8. Of the remaining asymptomatic subjects, about half(n=18) of these subjects also had an IVC/Ao ratio below the American threshold of ***: Our study did not support previous literature showing that the IVC/Ao ratio is lower in children with dehydration. It is possible that the American standard for evaluating clinical dehydration is not compatible with the rural pediatric populations of Panama.

关键词： Ultrasound Parasitic infection Panama Rural medicine Dehydration Medical education

Digital Twin in biomanufacturing:challenges and opportunities towards its implementation

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Systems Microbiology and Biomanufacturing 2021年第3期1卷 257-274页

作者： Isuru A.Udugama Pau C.Lopez carina L.Gargalo Xueliang Li Christoph Bayer Krist V.Gernaey Department of Chemical and Biochemical Engineering Process and Systems Engineering Center(PROSYS)Technical University of DenmarkBuilding 228 A2800 Kgs.LyngbyDenmark School of Biotechnology Jiangnan UniversityWuxi 214122JiangsuChina Department of Process Engineering TH Nürnberg90489 NurembergGermany

The domain of industrial biomanufacturing is enthusiastically embracing the concept of Digital Twin,owing to its promises of increased process efficiency and resource ***,Digital Twin in biomanufacturing is not yet clearly defined and this sector of the industry is falling behind the others in terms of its *** the other hand,some of the benefits of Digital Twin seem to overlap with the more established practices of process control and optimization,and the term is vaguely used in different *** an attempt to clarify this issue,we investigate this overlap for the specific case of fermentation operation,a central step in many biomanufacturing *** on this investigation,a framework built upon a five-step pathway starting from a basic steady-state process model is proposed to develop a fully-fledged Digital *** demonstration purposes,the framework is applied to a bench-scale second-generation ethanol fermentation process as a case *** is proposed that the success or failure of a fully-fledged Digital Twin implementation is determined by key factors that comprise the role of modelling,human operator actions,and other propositions of economic value.

关键词： Digital Twin fermentation Process control Modelling Biomanufacturing

Establishment,functional and genetic characterization of three novel patient-derived rectal cancer cell lines

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World Journal of Gastroenterology 2018年第43期24卷 4880-4892页

作者： Michael Gock Christina S Mullins carina Bergner friedrich Prall Robert Ramer Anja Goder Oliver H Kramer falko Lange Bernd J Krause Ernst Klar Michael Linnebacher Department of General Surgery University Medical CenterRostock 18055Germany Section of Molecular Oncology and Immunotherapy University MedicalCenterRostock 18055Germany Department of NuclearMedicine University Medical CenterRostock 18055Germany Institute of Pathology University MedicalCenterRostock 18055Germany Institute of Pharmacology University Medical CenterRostock 18055Germany Institute of Toxicology University Medical Center MainzMainz 55131Germany Oscar-Langendorff-Institute of Physiology University Medical CenterRostock 18055Germany

AIM To establish patient-individual tumor models of rectal cancer for analyses of novel biomarkers, individual response prediction and individual therapy *** Establishment of cell lines was conducted by direct in vitro culturing and in vivo xenografting with subsequent in vitro culturing. Cell lines were in-depth characterized concerning morphological features, invasive and migratory behavior, phenotype, molecular profile including mutational analysis, protein expression, and confirmation of origin by DNA fingerprint. Assessment of chemosensitivity towards an extensive range of current chemotherapeutic drugs and of radiosensitivity was performed including analysis of a combined radioand chemotherapeutic treatment. In addition, glucose metabolism was assessed with 18 f-fluorodeoxyglucose(fDG) and proliferation with 18 *** We describe the establishment of ultra-low passage rectal cancer cell lines of three patients suffering from rectal cancer. Two cell lines(HROC126, HROC284 Met) were established directly from tumor specimens while HROC239 T0 M1 was established subsequent to xenografting of the tumor. Molecular analysis classified all three cell lines as CIMP-0/non-MSI-H(sporadic standard) type. Mutational analysis revealed following mutational profiles: HROC126: APC^(wt), TP53^(wt), KRAS^(wt), BRAf^(wt), PTEN^(wt); HROC239 T0 M1: APC^(mut), P53^(wt), KRAS^(mut), BRAf^(wt), PTEN^(mut) and HROC284 Met: APC^(wt), P53^(mut), KRAS^(mut), BRAf^(wt), PTEN^(mut). All cell lines could be characterized as epithelial(EpCAM+) tumor cells with equivalent morphologic features and comparable growth kinetics. The cell lines displayed a heterogeneous response toward chemotherapy, radiotherapy and their combined application. HROC126 showed a highly radio-resistant phenotype and HROC284 Met was more susceptible to a combined radiochemotherapy than HROC126 and HROC239 T0 M1. Analysis of 18 f-fDG uptake displayed a markedly reduced fDG uptake of all th

关键词： Patient-derived tumor model Rectal cancer ^(18)f-fluorodeoxyglucose ^(18)f-fluorothymidine fOLfOX fOLfIRI Personalized medicine

Single-operator cholangioscopy for biliary complications in liver transplant recipients

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World Journal of Gastroenterology 2017年第22期23卷 4064-4071页

作者： Anna Hüsing-Kabar Hauke Sebastian Heinzow Hartmut Hans-Jürgen Schmidt carina Stenger Hans Ulrich Gerth Michele Pohlen Gerold Tholking Christian Wilms Iyad Kabar Department of Transplant Medicine University Hospital Muenster Department of Medicine D Division of General Internal MedicineNephrology and RheumatologyUniversity Hospital Muenster Department of Medicine A Hematology and OncologyUniversity Hospital Muenster

To evaluate cholangioscopy in addition to endoscopic retrograde cholangiopancreatography (ERCP) for management of biliary complications after liver transplantation (LT).METHODSTwenty-six LT recipients with duct-to-duct biliary reconstruction who underwent ERCP for suspected biliary complications between April and December 2016 at the university hospital of Muenster were consecutively enrolled in this observational study. After evaluating bile ducts using fluoroscopy, cholangioscopy using a modern digital single-operator cholangioscopy system (SpyGlass DS™) was performed during the same procedure with patients under conscious sedation. All patients received peri-interventional antibiotic prophylaxis and bile was collected during the intervention for microbial analysis and for antibiotic susceptibility ***-three biliary complications were found in a total of 22 patients, whereas four patients showed normal bile ducts. Anastomotic strictures were evident in 14 (53.8%) patients, non-anastomotic strictures in seven (26.9%), biliary cast in three (11.5%), and stones in six (23.1%). A benefit of cholangioscopy was seen in 12 (46.2%) patients. In four of them, cholangioscopy was crucial for selective guidewire placement prior to planned intervention. In six patients, biliary cast and/or stones failed to be diagnosed by ERCP and were only detectable through cholangioscopy. In one case, a bile duct ulcer due to fungal infection was diagnosed by cholangioscopy. In another case, signs of bile duct inflammation caused by acute cholangitis were evident. One patient developed post-interventional cholangitis. No further procedure-related complications occurred. Thirty-seven isolates were found in bile. Sixteen of these were gram-positive (43.2%), 12 (32.4%) were gram-negative bacteria, and Candida species accounted for 24.3% of all isolated microorganisms. Interestingly, only 48.6% of specimens were sensitive to prophylactic ***-operator c

关键词： Cholangioscopy Endoscopic retrograde cholangiopancreatography Liver transplantation Biliary complications Biliary strictures

Life before Myocardial Infarction<br/>—A Qualitative Study of Middle-Aged Women

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Health 2014年第20期6卷 2765-2774页

作者： carina Wennerholm Michaela Jern Marja-Liisa Honkasalo Tomas faresjö Department of Medicine and Health Sciences Community Medicine/General Practice Link&ouml ping University Link&ouml ping Sweden Center for the Study of Culture and Health University of Turku Turku Finland

The health burden of myocardial infarction is rising for middle-aged women and they are underrepresented in research of cardiovascular diseases. The aim of this qualitative study was to explore how life had been for middle-aged women before they suffered a myocardial infarction (MI). Through a health care register, we identified all women (n = 46) under 65 years of age in a defined region in southeast Sweden who had suffered an MI the past 2 years and a strategic selection of n = 16 women from these was made. These selected women were interviewed and their narratives were interpreted by qualitative content analysis. The qualitative interviews generated five general themes: “Serious life events”, “Negative affectivity”, “Loneliness”, “Being a good girl” and “Lack of control”. The interviews revealed that many of these women had been exposed to extreme and repeated traumatic life events in their lives. Many had a cynical attitude towards others, felt lonely and experienced a lack of social support. Many of these women endeavored to “be a good girl”, which was a special psychosocial phenomenon found. This study uncovered that these women before they suffered an MI were affected by a variety of psychosocial factors. The study stresses the importance of psychosocial risk factors in the assessment of middle-aged women’s risk profile for MI. A general conclusion for clinical practice is that in the assessment of the individual risk for myocardial infarction for middle-aged women, potential psychosocial factors might also be considered.

关键词： Myocardial Infarction Women Risk factors Psychosocial factors Qualitative Research

Glucose-6-phosphate-dehydrogenase deficiency and its correlation with other risk factors in jaundiced newborns in Southern Brazil

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Asian Pacific Journal of Tropical Biomedicine 2011年第2期1卷 110-113页

作者： Clarissa Gutirrez Carvalho Simone Martins Castro Ana Paula Santin carina Zaleski felipe Gutirrez Carvalho Roberto Giugliani Genetics Service Hospital de Clinicas de Porto AlegrePGP in PediatricsUFRGS Pharmacy School UFRGS Medical School UFRGS

Objective:To evaluate the correlation between glucose-6-phosphate-dehydrogenase(G6PD) deficiency and neonatal ***:Prospective,observational case-control study was conducted on 490 newborns admitted to Hospital de Clinicas de Porto Alegre for phototherapy, who all experienced 35 or more weeks of gestation,from March to December *** screening of G6PD activity was performed,followed by ***:There was prevalence of 4.6% and a boy-girl ratio of 3:1 in jaundiced *** jaundiced neonate with ABO incompatibility presented G6PD deficiency,and no Mediterranean mutation was found.A higher proportion of deficiency was observed in *** was no association with UGT1A1 variants. Conclusions:G6PD deficiency is not related to severe hyperbilirubinemia and considering the high miscegenation in this area of Brazil,other gene interactions should be investigated.

关键词： Glucosephosphate dehydrogenase Jaundice Hyperbilirubinemia Neonatal Hemoglobin

Building Envelope Rehabilitation Costs： Determination and Variability

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Journal of Civil Engineering and Architecture 2012年第3期6卷 300-307页

作者： carina Isabel Pereira de Sousa Joao Carlos Goncalves Lanzinha Civil Engineering and Architecture Department Faculty of Engineering University of Beira Interior Covilh6 Portugal

In recent decades, there has been a great deal of investment in Portugal in the construction of new buildings to the detriment of the rehabilitation of existing ones. As a result, the historic centres of towns and cities are deteriorating, while their suburbs are spreading. One of the main problems affecting the rehabilitation of residential buildings is that it is extremely difficult to accurately estimate the costs involved. Although there are established methods （and technical documents available） to aid the costing of new buildings, there is a lack of official information about the costs of rehabilitation work, particularly as regards the external envelope of buildings. This article demonstrates how to determine rehabilitation costs （with particular emphasis on the envelope of residential buildings） by gathering information from specialized companies, assessing price variability and consulting databases of rehabilitation costs from other countries. It also presents some examples of costing for particular rehabilitation jobs.

关键词： Rehabilitation building envelope costs.

Assessing neuraxial microstructural changes in a transgenic mouse model of early stage Amyotrophic Lateral Sclerosis by ultra-high field MRI and diffusion tensor metrics

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Animal Models and Experimental Medicine 2020年第2期3卷 117-129页

作者： Rodolfo G.Gatto carina Weissmann Manish Amin Ariel finkielsztein Ronen Sumagin Thomas H.Mareci Osvaldo D.Uchitel Richard L.Magin Department of Bioengineering University of Illinois at ChicagoChicagoILUSA Instituto de fisiología Biologia Molecular y Neurociencias-IfIBYNE-CONICET University of Buenos AiresBuenos AiresArgentina Department of Biochemistry National High Magnetic Field LaboratoryUniversity of FloridaGainesvilleFLUSA Department of Pathology School of MedicineNorthwestern UniversityChicagoILUSA

Objective: Cell structural changes are one of the main features observed during the development of amyotrophic lateral sclerosis(ALS). In this work, we propose the use of diffusion tensor imaging(DTI) metrics to assess specific ultrastructural changes in the central nervous system during the early neurodegenerative stages of ***: Ultra-high field MRI and DTI data at 17.6 T were obtained from fixed, excised mouse brains, and spinal cords from ALS(G93 A-SOD1) ***: Changes in fractional anisotropy(fA) and linear, planar, and spherical anisotropy ratios(C_L, C_P, and C_S, respectively) of the diffusion eigenvalues were measured in white matter(WM) and gray matter(GM) areas associated with early axonal degenerative processes(in both the brain and the spinal cord). Specifically, in WM structures(corpus callosum, corticospinal tract, and spinal cord funiculi) as the disease progressed, fA, C_L, and C_P values decreased, whereas C_S values increased. In GM structures(prefrontal cortex, hippocampus, and central spinal cord) fA and C_P decreased, whereas the C_L and C_S values were unchanged or slightly smaller. Histological studies of a fluorescent mice model(YfP, G93 A-SOD1 mouse) corroborated the early alterations in neuronal morphology and axonal connectivity measured by ***: Changes in diffusion tensor shape were observed in this animal model at the early, nonsymptomatic stages of ALS. further studies of C_L, C_P, and C_S as imaging biomarkers should be undertaken to refine this neuroimaging tool for future clinical use in the detection of the early stages of ALS.

关键词： amyotrophic lateral sclerosis animal models diffusion tensor imaging G93A-SOD1 mice ultra-high field MRI

Pilot study on the Non-Invasive Detectability of femoral Neck fractures with frequency Response functions

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World Journal of Mechanics 2014年第7期4卷 210-216页

作者： Wolfgang Witteveen carina Wagner Patrick Jachs Stefan froschauer Harald Schoffl Upper Austrian University of applied Sciences WelsAustria BioMed-zet Life Science GmbH LinzAustria

A suspicion of a femoral neck fracture is a frequently recurring situation, especially in nursing homes. for the clarification of such a suspicion normally imaging techniques are used. Such equipment is expensive and therefore is located in hospitals. In addition to the costs, a transport causes stress for the patient. This pilot study is devoted to the question whether the detection of a femoral neck fracture with vibration measurements is possible in principal. In such a case, the clarification could be done on-site by an ordinary person using much cheaper equipment. This would reduce the stress for the patient and save money. for this purpose vibration measurements on a dead body with intact, with partially fractured and with complete cut femoral neck have been performed. Two different methods for the vibration initiation have been investigated, the so called impact testing and the shaker testing. The frequency response function has been determined for all combinations on both sides of the body. It turned out that there is a clear difference in the frequency response functions of the fractured bone with respect to the intact bone when shaker testing is used. This indicates that the method could have the potential to be a cost-saving alternative to imaging techniques. However, in a next step a statistically reliable clinical survey on living persons needs to be done.

关键词： Biomechanics Vibrations frequency Response function fRf femoral Neck fracture