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Purpose: To evaluate the effect of reduced z-axis scan coverage on diagnostic performance and radiation dose of neck CT in patients with suspected cervical abscess.
Methods: Fifty-one patients with suspected cervical abscess were included and underwent contrast-enhanced neck CT on a 2nd or 3rd generation dual-source CT system. Image acquisition ranged from the aortic arch to the upper roof of the frontal sinuses (CTstd). Subsequently, series with reduced z-axis coverage (CTred) were reconstructed starting at the aortic arch up to the orbital floor. CTstd and CTred were independently assessed by two radiologists for the presence/absence of cervical abscesses and for incidental and alternative findings. In addition, diagnostic accuracy for the depiction of the cervical abscesses was calculated for both readers. Furthermore, DLP (dose-length-product), effective dose (ED) and organ doses were calculated and compared for CTred and CTstd, using a commercially available dose management platform.
Results: A total of 41 abscesses and 3 incidental/alternative findings were identified in CTstd. All abscesses and incidental/alternative findings could also be detected on CTred resulting in a sensitivity and specificity of 1.0 for both readers. DLP, ED and organ doses of the brain, the eye lenses, the red bone marrow and the salivary glands of CTred were significantly lower than for CTstd (p<0.001).
Conclusions: Reducing z-axis coverage of neck CT allows for a significant reduction of effective dose and organ doses at similar diagnostic performance as compared to CTstd.
The paper present the results of a new field collection of myxomycetes (plasmodial slime moulds) on dead wood, dead bark and litter substrate in southeast New South Wales centred on Canberra (lat. 35° S, long. 149° E). The sample consists of 96 species from 493 collections. This survey is compared with four other surveys for similar substrates and similar temperate climate: southwest Western Australia, southeast Australia, New Zealand and Patagonia. The assemblages are similar in species composition and abundance, when allowance is made for the large random effect in the sampling. These five southern hemisphere assemblages have been combined into a composite assemblage. This composite assemblage is similar to those of the Iberian Peninsula (Spain and Portugal) and Britain, when allowance is made for the varying sampling of litter. This similarity may represent a single species assemblage occurring in both the Southern and Northern Hemispheres in areas of similar temperate climate.
Ongoing liver inflammation in patients with chronic hepatitis C and sustained virological response
(2017)
Background: Novel direct-acting antiviral DAA combination therapies tremendously improved sustained virologic response (SVR) rates in patients with chronic HCV infection. SVR is typically accompanied by normalization of liver enzymes, however, hepatic inflammation, i.e. persistently elevated aminotransferase levels may persist despite HCV eradication. Aim: To investigate prevalence and risk factors for ongoing hepatic inflammation after SVR in two large patient cohorts.
Methods: This post-hoc analysis was based on prospectively collected demographic and clinical data from 834 patients with SVR after HCV treatment with either PegIFN- or DAA-based treatment regimens from the PRAMA trial (n = 341) or patients treated at our outpatient clinic (n = 493).
Results: We observed an unexpected high prevalence of post-SVR inflammation, including patients who received novel IFN-free DAA-based therapies. Up to 10% of patients had ongoing elevation of aminotransferase levels and another 25% showed aminotransferase activity above the so-called healthy range. Several baseline factors were independently associated with post-SVR aminotransferase elevation. Among those, particularly male gender, advanced liver disease and markers for liver steatosis were strongly predictive for persistent ALT elevation. The use of IFN-based antiviral treatment was independently correlated with post-SVR inflammation, further supporting the overall benefit of IFN-free combination regimens.
Conclusion: This is the first comprehensive study on a large patient cohort investigating the prevalence and risk factors for ongoing liver inflammation after eradication of HCV. Our data show a high proportion of patients with ongoing hepatic inflammation despite HCV eradication with potential implications for the management of approximately one third of all patients upon SVR.
"Ihr sollt euch nicht zu den Götzen wenden, und gegossene Götter sollt ihr euch nicht machen [...](Lev 19,4) [...] sollen wir nicht meinen, daß das Göttliche dem Gold und Silber oder Stein, einem Gebilde der Kunst und der Erfindung des Menschen gleich sei. (Acta 17,29) Pfui über euch und über das, was ihr an Gottes Statt verehrt! [...] (Q 21,67)"
Diese drei Sätze stammen nacheinander aus der hebräischen Bibel, dem Neuen Testament und dem Koran. Man kann sie beinahe wie einen Text lesen, an dem sich die These des Ägyptologen Jan Assmann belegen ließe, dass mit der Herausbildung monotheistischer Religionen wie Judentum, Christentum und Islam im Allgemeinen und dem Bilderverbot im Besonderen die Unterscheidung zwischen wahr und falsch in die Götterwelt gekommen sei (Assmann 1998, S. 17). ...
Durch die stille Luft glitt eine Taube herab und schwebte zärtlich Aretulla dort, wo sie saß, geradewegs auf den Schoß. Ein Spiel des Zufalls konnte das nicht sein, doch sie blieb, ohne daß man sie bewachte, und weigerte sich wegzufliegen, obwohl ihr die Flucht erlaubt war. Wenn es der liebenden Schwester vergönnt ist, auf eine Besserung der Lage zu hoffen, und wenn Bitten den Herrn der Welt zu rühren vermögen, dann ist dieser Vogel vielleicht von den sardischen Küsten des Verbannten zu dir als ein Bote gekommen, und dein Bruder wird alsbald zurückkehren. ...
For a chaotic system pairs of initially close-by trajectories become eventually fully uncorrelated on the attracting set. This process of decorrelation can split into an initial exponential decrease and a subsequent diffusive process on the chaotic attractor causing the final loss of predictability. Both processes can be either of the same or of very different time scales. In the latter case the two trajectories linger within a finite but small distance (with respect to the overall extent of the attractor) for exceedingly long times and remain partially predictable. Standard tests for chaos widely use inter-orbital correlations as an indicator. However, testing partially predictable chaos yields mostly ambiguous results, as this type of chaos is characterized by attractors of fractally broadened braids. For a resolution we introduce a novel 0-1 indicator for chaos based on the cross-distance scaling of pairs of initially close trajectories. This test robustly discriminates chaos, including partially predictable chaos, from laminar flow. Additionally using the finite time cross-correlation of pairs of initially close trajectories, we are able to identify laminar flow as well as strong and partially predictable chaos in a 0-1 manner solely from the properties of pairs of trajectories.
The article delineates the development of nominal synthetic compounding in the history of German. In particular, it is attested an enhancement of the morphological structure which correlates with a morphological intersection of determinative compounding happening from Early New High German onwards.
Objetivo: sistematizar as potencialidades e desafios da Teoria do Reconhecimento, de Axel Honneth, e refletir sobre eles como subsídio às pesquisas em saúde.
Método: trata-se de artigo de reflexão que toma o potencial da incorporação da categoria reconhecimento na propositura honnethiana para pesquisa, compreensão, exercício e gestão do cuidado em saúde.
Resultados: o processo de reconhecimento favorece a exploração e a compreensão das relações de poder e respeito, sobretudo em termos do conflito a elas circunscrito. Dessa forma, indica subsídios para diagnósticos e núcleos estruturantes para a superação de práticas opressivas e desiguais, com desdobramentos para lidar com situações de insegurança, fragilidades na autoestima e vulnerabilidades nas interações entre os sujeitos, que configuram desafios contemporâneos.
Conclusão: na exploração científica do cuidado, gestão e políticas públicas em saúde, este referencial teórico pode auxiliar na visibilidade do contexto e seus nós críticos, para favorecer a autonomia e a dignidade humana, relevantes para as relações interpessoais nos processos de cuidado, com contribuições profícuas à qualificação da atenção à saúde.
Objective: to systematize the strengths and challenges of Axel Honneth’s Theory of Recognition, and to reflect on these as support for research in health care. Method: this is a reflection article which considers the potential of incorporating the category of recognition in the Honnethian proposition for research, understanding, exercising of practice and management of health care. Results: the process of recognition promotes the exploration and understanding of relations of power and respect, above all in terms of conflict which are ascribed to these. As a result, it indicates support for diagnoses and structuring nuclei for overcoming oppressive and unequal practices, with consequences for dealing with situations of insecurity, weaknesses in self-esteem and vulnerabilities in the interactions between the subjects, which are configured as contemporary challenges. Conclusion: in the scientific exploration of care, management and public policies in health, this theoretical framework can assist in the visibility of the context and in its critical knots, in order to promote autonomy and human dignity, which are relevant for the interpersonal relations in the processes of care, with fruitful contributions to the qualification of the health care.
In search for new natural products, which may lead to the development of new drugs for all kind of applications, novel methods are needed. Here we describe the identification of electrophilic natural products in crude extracts via their reactivity against azide as a nucleophile followed by their subsequent enrichment using a cleavable azide-reactive resin (CARR). Using this approach, natural products carrying epoxides and α,β-unsaturated enones as well as several unknown compounds were identified in crude extracts from entomopathogenic Photorhabdus bacteria.