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Does the use of double hormone replacement therapy for trauma patient organ donors improve organ recovery for transplant

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World Journal of Transplantation 2024年第2期14卷 119-125页

作者： Eden M Gallegos Tanner Reed Paige Deville Blake Platt claudia Leonardi Lillian Bellfi Jessica Dufrene Saad Chaudhary John Hunt Lance Stuke Patrick Greiffenstein Jonathan Schoen Alan Marr Anil Paramesh Alison A Smith Department of Physiology Louisiana State University Health Sciences Center New OrleansNew OrleansLA 70124United States Department of Medicine Louisiana State University Health Sciences Center New OrleansNew OrleansLA 70112United States Department of Surgery Louisiana State University Health Sciences Center New OrleansNew OrleansLA 70112United States Department of Trauma Surgery Tacoma General HospitalTacoma 98405United States Department of Public Health Louisiana State University Health Sciences Center New OrleansNew OrleansLA 70112United States Department of Donation Services Louisiana Organ Procurement AgencyCovingtonLA 70433United States Department of Surgery Tulane Transplant InstituteTulane University School of MedicineNew OrleansLA 70112United States

BACKGROUND With an ongoing demand for transplantable organs,optimization of donor management protocols,specifically in trauma populations,is important for obta-ining a high yield of viable organs per *** management of brain-dead potential organ donors(BPODs)is controversial,leading to heterogeneous clinical management *** studies have shown that when levo-thyroxine was combined with other treatments,including steroids,vasopressin,and insulin,BPODs had better organ recovery and survival outcomes were increased for transplant *** To determine if levothyroxine use in combination with steroids in BPODs increased the number of organs donated in trauma *** A retrospective review of adult BPODs from a single level 1 trauma center over ten years was *** criteria included patients who were not solid organ donors,patients who were not declared brain dead(donation after circulatory death),and patients who did not receive steroids in their hospital *** and steroid administration,the number of organs donated,the types of organs donated,and demographic information were *** analyses were performed with P0.05).In the ST/LT group,68.1%(n=47)donated a high yield(3-5)of organ types per donor compared to 42.1%(n=8)in the ST group(P=0.038).There was no difference in the total number of organ types donated between the groups(P=0.068).CONCLUSION This study suggests that combining levothyroxine and steroid administration increases high-yield organ donation per donor in BPODs in the trauma patient *** to this study include

关键词： Organ donation Trauma Brain death Levothyroxine Hormone replacement therapy Steroids Organ donor Retrospective

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在不确定的环境中管理银行风险

中国金融 2024年第8期 12-13页

作者：克劳迪娅·布赫肖林(译) 欧洲中央银行监事会中国人民银行广东省分行

一年前,在美国和瑞士爆发的银行危机考验了银行体系的抗风险能力。欧洲的银行较好地经受住了风暴的洗礼--这既要归功于银行自身的韧性,也有赖于相关国家监管机构快速实施的应对措施。行业动荡再次提醒我们,维护金融稳定需要良好的风险... 详细信息

一年前,在美国和瑞士爆发的银行危机考验了银行体系的抗风险能力。欧洲的银行较好地经受住了风暴的洗礼--这既要归功于银行自身的韧性,也有赖于相关国家监管机构快速实施的应对措施。行业动荡再次提醒我们,维护金融稳定需要良好的风险管理和公司治理、迅速而有针对性的政策响应,并时刻对宏观经济风险保持高度警惕。尽管市场人士对现阶段经济前景依然相对乐观,但也应注意到,一些长期趋势正在发生变化,外部环境也充斥着不确定性。

关键词：银行风险宏观经济风险抗风险能力银行体系政策响应风险管理监管机构外部环境

Assessment of the Indirect Cost of Drug Resistant Tuberculosis Treatment to Patients in a High Burden, Low Income Setting in Mozambique

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Journal of Tuberculosis Research 2024年第2期12卷 91-104页

作者： Júlia Malache António Domingas Pacala Isabelle Munyangaju Isaías Benzana claudia Mutaquiha Dulce Osório Benedita José Edy Nacarapa Pereira Zindoga Faculdade de Cincias de Sade Universidade Catlica de Moambique Beira Moambique Programa Nacional de Controlo da Tuberculose Ministrio da Sade de Moambique Maputo Moambique ISGlobal Hospital Clnic Universitat de Barcelona Barcelona Spain Tinpswalo Association Vincentian Association to Fight AIDS and TB Chokwe Mozambique Centro de Estudos e Apoio Psicolgico (CEAP) Universidade Eduardo Mondlane Maputo Moambique

Introduction: Tuberculosis is closely linked to poverty, with patients facing significant indirect treatment costs. Treating drug-resistant tuberculosis further increases these expenses. Notably, there is a lack of published data on the indirect costs incurred by patients with drug-resistant tuberculosis in Mozambique. Objective: To assess the indirect costs, income reduction, and work productivity incurred by patients undergoing diagnosis and treatment for Drug-Resistant Tuberculosis (DRTB) in Mozambique during their TB treatment. Methods: As part of a comprehensive mixed-methods study conducted from January 2021 to April 2023, this research utilized a descriptive cross-sectional approach, incorporating both quantitative and qualitative methods. The primary goal was to evaluate the costs incurred by the national health system due to drug-resistant TB. Additionally, to explore the indirect costs experienced by patients and their families during treatment, semi-structured interviews were conducted with 27 individuals who had been undergoing treatment for over six months. Results: All survey participants unanimously reported a significant decline in labour productivity, with 70.3% experiencing a reduction in their monthly income. Before falling ill, the majority of respondents (33.3%) earned up to $76.92 monthly, representing the minimum earnings range, while 29.2% had a monthly income above $230.77, the maximum earnings range. Among those who experienced income loss, the majority (22.2%) reported a decrease of up to $76.92 per month, and 18.5% cited a loss exceeding $230.77 per month. Notably, patients with Drug-Resistant Tuberculosis (DRTB) have not incurred the direct costs of the disease, as these are covered by the government. Conclusion: The financial burden of treating Drug-Resistant Tuberculosis (DRTB), along with the income reduction it causes, is substantial. Implementing a patient-centred, multidisciplinary, and multisector approach, coupled with strong psy

关键词： Economic Costs Drug Resistance Tuberculosis Catastrophic Costs

Statistical Analysis of Abilities to Give Consent to Health Data Processing

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Applied Mathematics 2024年第8期15卷 508-542页

作者： Antonella Massari Biagio Solarino Paola Perchinunno Angela Maria D’Uggento Marcello Benevento Viviana D’Addosio Vittoria claudia De Nicolò Samuela L’Abbate Department of Economics Management and Business Law University of Bari Aldo Moro Bari Italy Institute of Legal Medicine Department of Interdisciplinary Medicine University of Bari Aldo Moro Bari Italy Department of Economics and Finance University of Bari Aldo Moro Bari Italy

The recent pandemic crisis has highlighted the importance of the availability and management of health data to respond quickly and effectively to health emergencies, while respecting the fundamental rights of every individual. In this context, it is essential to find a balance between the protection of privacy and the safeguarding of public health, using tools that guarantee transparency and consent to the processing of data by the population. This work, starting from a pilot investigation conducted in the Polyclinic of Bari as part of the Horizon Europe Seeds project entitled “Multidisciplinary analysis of technological tracing models of contagion: the protection of rights in the management of health data”, has the objective of promoting greater patient awareness regarding the processing of their health data and the protection of privacy. The methodology used the PHICAT (Personal Health Information Competence Assessment Tool) as a tool and, through the administration of a questionnaire, the aim was to evaluate the patients’ ability to express their consent to the release and processing of health data. The results that emerged were analyzed in relation to the 4 domains in which the process is divided which allows evaluating the patients’ ability to express a conscious choice and, also, in relation to the socio-demographic and clinical characteristics of the patients themselves. This study can contribute to understanding patients’ ability to give their consent and improve information regarding the management of health data by increasing confidence in granting the use of their data for research and clinical management.

关键词： Privacy Health Data Consent Cluster Analysis Logit

From strength to precision: A systematic review exploring the clinical utility of 7-Tesla magnetic resonance imaging in abdominal imaging

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World Journal of Radiology 2024年第1期16卷 20-31页

作者： Arosh S Perera Molligoda Arachchige Ana claudia Teixeira de Castro Gonçalves Ortega Federica Catapano Letterio S Politi Michael N Hoff Faculty of Medicine Humanitas UniversityPieve Emanuele 20072MilanItaly Department of Biomedical Sciences Humanitas UniversityPieve Emanuele 20072MilanItaly IRCCS Humanitas Research Hospital Rozzano 20089MilanItaly Department of Neuroradiology IRCCS Humanitas Research HospitalRozzano 20089MilanItaly Department of Radiology and Biomedical Imaging University of CaliforniaSan FranciscoCA 94143United States

BACKGROUND After approval for clinical use in 2017 early investigations of ultra-high-field abdominal magnetic resonance imaging(MRI)have demonstrated the feasibility as well as diagnostic capabilities of liver,kidney,and prostate MRI at ***,the elevation of the field strength to 7-Tesla not only brought advantages to abdominal MRI but also presented considerable challenges and drawbacks,primarily stemming from heightened artifacts and limitations in Specific Absorption Rate,***,evidence in the literature is relatively scarce concerning human studies in comparison to phantom/animal studies which necessitates an investigation into the evidence so far in humans and summarizing all relevant *** To offer a comprehensive overview of current literature on clinical abdominal 7T MRI that emphasizes current trends,details relevant challenges,and provides a concise set of potential *** This systematic review adheres to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.A PubMed search,utilizing Medical Subject Headings terms such as"7-Tesla"and organ-specific terms,was conducted for articles published between January 1,1985,and July 25,*** criteria included studies exploring 7T MRI for imaging human abdominal organs,encompassing various study types(in-vivo/ex-vivo,method development,reviews/meta-analyses).Exclusion criteria involved animal studies and those lacking extractable *** selection involved initial identification via title/abstract,followed by a full-text review by two researchers,with discrepancies resolved through *** extraction covered publication details,study design,population,sample size,7T MRI protocol,image characteristics,endpoints,and *** The systematic review included a total of 21 *** distribution of clinical 7T abdominal imaging studies revealed a predominant focus on the prostate(n=8),followed by the kidney(n=6)and the hepato

关键词： 7-Tesla magnetic resonance imaging Abdominal Prostate Kidney Renal Pancreas Hepatobiliary Liver Small bowel

A comprehensive review of genetic causes of obesity

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World Journal of Pediatrics 2024年第1期20卷 26-39页

作者： Marcio Jose Concepcion-Zavaleta Juan Eduardo Quiroz-Aldave Maria del Carmen Durand-Vasquez Elman Rolando Gamarra-Osorio Juan del Carmen Valencia de la Cruz claudia Mercedes Barrueto-Callirgos Susan Luciana Puelles-Leon Elena de Jesus Alvarado-Leon Frans Leiva-Cabrera Francisca Elena Zavaleta-Gutierrez Luis Alberto Concepcion-Urteaga Jose Paz-Ibarra Universidad Cientifica del Sur Bolivar 2150 AvenuePueblo Libre15084LimaPeru Division of Medicine Hospital de Apoyo ChepénChepenPeru Division of Family Medicine Hospital de Apoyo ChepénChepenPeru Division of Endocrinology Hospital Victor Lazarte EchegarayTrujilloPeru Division of Pediatrics Hospital de Apoyo ChepenChepenPeru Division of Internal Medicine Hospital de Apoyo ChepenChepenPeru Division of Genetics Universidad Nacional de TrujilloTrujilloPeru Division of Neonatology Hospital Belen de TrujilloTrujilloPeru Division of Internal Medicine Universidad Nacional de TrujilloTrujilloPeru Department of Medicine School of MedicineUniversidad Nacional Mayor de San MarcosLimaPeru

Background Obesity is a multifactorial chronic disease with a high,increasing worldwide *** causes account for 7%of the cases in children with extreme *** sources This narrative review was conducted by searching for papers published in the PubMed/MEDLINE,Embase and SciELO databases and included 161 *** search used the following search terms:"obesity","obesity and genetics","leptin","Prader-Willi syndrome",and"melanocortins".The types of studies included were systematic reviews,clinical trials,prospective cohort studies,cross-sectional and prospective studies,narrative reviews,and case *** The leptin-melanocortin pathway is primarily responsible for the regulation of appetite and body ***,several important aspects of the pathophysiology of obesity remain *** causes of obesity can be grouped into syndromic,monogenic,and polygenic causes and should be assessed in children with extreme obesity before the age of 5 years,hyperphagia,or a family history of extreme obesity.A microarray study,an analysis of the melanocortin type 4 receptor gene mutations and leptin levels should be performed for this *** are three therapeutic levels:lifestyle modifications,pharmacological treatment,and bariatric *** Genetic study technologies are in constant development;however,we are still far from having a personalized approach to genetic causes of obesity.A significant proportion of the affected individuals are associated with genetic causes;however,there are still barriers to its approach,as it continues to be underdiagnosed.

关键词： Leptin Melanocortin Obesity Prader-Willi syndrome Precision medicine

An Analysis of the Accounting Costs Associated with 20-Month DR TB Regimens in Maputo City, Mozambique

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Journal of Tuberculosis Research 2024年第2期12卷 73-90页

作者： Júlia Malache António Isaías Benzana Isabelle Munyangaju Benedita José Dulce Osório Edy Nacarapa claudia Mutaquiha Simeão Nhabinde Pereira Zindoga Universidade Catlica de Moambique Beira Moambique Centro de Estudos e Apoio Psicolgico (CEAP) Universidade Eduardo Mondlane Maputo Moambique ISGlobal Hospital Clnic Universitat de Barcelona Barcelona Spain Tinpswalo Association Vincentian Association to Fight AIDS and TB Chokwe Mozambique Programa Nacional de Controlo da Tuberculose Ministrio da Sade de Moambique Maputo Mozambique Faculdade de Economia Universidade Eduardo Mondlane Maputo Moambique

Introduction: Socioeconomic and demographic conditions in a country can influence tuberculosis incidence and mortality, with nearly 95% of tuberculosis-related deaths occurring in poorer countries. Mozambique is among the 30 countries with the highest TB burden. Objective: The study aimed to estimate the average direct medical cost of treating drug-resistant tuberculosis in 19 health centers in Maputo City, Mozambique. Methods: A retrospective analysis of direct medical costs was conducted on patients aged 18 and older who completed 20-month drug-resistant tuberculosis treatment regimens in Maputo City in 2019. Results: This analysis covered 140 patients who completed a 20-month treatment regimen, with 64.3% (78) being male and 35.7% (62) female. Approximately 50% of the participants were aged between 29 and 47. The average direct medical cost of DRTB treatment was $4789.43, reaching up to $6568.00, with a standard deviation of $753.26, including clinical interventions and treatment. Conclusion: The direct medical costs for a basic treatment package for a patient with drug-resistant TB in Mozambique equal 36 minimum wages. Developing alternative and innovative funding mechanisms and identifying ways to mitigate costs through the use of generic medicines would be beneficial.

关键词： Antitubercular Agents Multidrug-Resistant Healthcare Costs Tuberculosis Mozambique

Crystal structure evolution of complex metal aluminum hydrides upon hydrogen release

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Journal of Energy Chemistry 2020年第3期29卷 133-143页

作者： claudia Weidenthaler Max-Planck-Institut für Kohlenforschung 45470 Mülheim an der RuhrGermany

Complex aluminum hydrides have been widely studied as potential hydrogen storage materials but also,for some time now, for electrochemical applications. This review summarizes the crystal structures of alkali and alkaline earth aluminum hydrides and correlates structure properties with physical and chemical properties of the hydride compounds. The crystal structures of the alkali metal aluminum hydrides change significantly during the stepwise dehydrogenation. The general pathway follows a transformation of structures built of isolated [AlH4]- tetrahedra to structures built of isolated [Al H6]3- *** crystal structure relations in the group of alkaline earth metal aluminum hydrides are much more complicated than those of the alkali metal aluminum hydrides. The structures of the alkaline earth metal aluminum hydrides consist of isolated tetrahedra but the intermediate structures exhibit chains of cornershared octahedra. The coordination numbers within the alkali metal group increase with cation sizes which goes along with an increase of the decomposition temperatures of the primary hydrides. Alkaline earth metal hydrides have higher coordination numbers but decompose at slightly lower temperatures than their alkali metal counterparts. The decomposition pathways of alkaline metal aluminum hydrides have not been studied in all cases and require future research.

关键词： Complex aluminum hydrides Hydrogen storage Crystal structure

HOMOGENIZATION RESULTS FOR ENZYME CATALYZED REACTIONS THROUGH POROUS MEDIA

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Acta Mathematica Scientia 2009年第1期29卷 74-82页

作者： claudia Timofte Department of Mathematics Faculty of Physics University of BucharestP.O. Box MG-11

The aim of this article is to study the effective behavior of the solution of a nonlinear problem arising in the modelling of enzyme catalyzed reactions through the exterior of a domain containing periodically distributed reactive solid obstacles,with period ε.The asymptotic behavior of the solution of such a problem is governed by a new elliptic boundary-value problem,with an extra zero-order term that captures the effect of the enzymatic reactions.

关键词： Homogenization enzyme reactive flows Michaelis-Menten mechanism