155155 research outputs found
Sort by
التعليم و سياسات الخصخصة: ما بين الخدمة والاستثمار
No full textThe chapter analyses privatisation reforms of Egyptian education from the 1980s to the present, focusing on expansion of fee-charging public schools targeting the middle classes. The chapter argues that Egyptian education policy has departed from a welfarist conception of education as public service by adopting a market-driven logic that presents education as investment
Outcome in pediatric celiac disease is independent of the diagnostic approach in patients with high antibody levels.
No full textOBJECTIVES
European Society for Paediatric Gastroenterology, Hepatology and Nutrition guidelines enable the diagnosis of celiac disease (CD) without biopsies in patients with immunoglobulin A (IgA)-antibodies against tissue transglutaminase (TGA-IgA) ≥ 10× the upper limit of normal (ULN) and positivity of endomysial antibodies in a second blood sample. Limited data exist comparing the biopsy versus the nonbiopsy diagnostic approach regarding long-term outcomes in CD patients. Our study aimed to investigate the influence of the diagnostic approach on adherence to gluten-free diet (GFD), serological remission (defined as normalization of TGA-IgA during follow-up (FU)) and clinical remission in CD patients with TGA-IgA ≥ 10× ULN.
METHODS
Retrospective multicenter study. Patients with CD and TGA-IgA ≥ 10× ULN at diagnosis were included in the study. Patients with confirmed diagnosis by biopsy were compared to patients diagnosed by nonbiopsy approach using univariate analysis, Kaplan-Meier survival curve, and logistic regression models.
RESULTS
A total of 282 CD patients (192 [68.1%] in the biopsy group; 90 [31.9%] in the nonbiopsy group) were analyzed. The median time to normalization of TGA-IgA was 16.5 months [interquartile range, IQR: 13, 28] in the biopsy and 15 months [IQR: 12, 26] in the nonbiopsy group; p = 0.14). Rates of normalized TGA-IgA at first to third-year FU were comparable between both groups. Adherence to GFD did not seem to be influenced by the diagnostic approach.
CONCLUSIONS
The nonbiopsy approach is not inferior to the biopsy approach in terms of adherence to GFD and serological remission in patients with CD
Convective environments in AI-models - What have AI-models learned about atmospheric profiles?
Get PDFThe recently released suite of AI-based medium-range forecast models can produce multi-day forecasts within seconds, with a skill on par with the IFS model of ECMWF. Traditional model evaluation predominantly targets global scores on single levels. Specific prediction tasks, such as severe convective environments, require much more precision on a local scale and with the correct vertical gradients in between levels. With a focus on the North American and European convective season of 2020, we assess the performance of Panguweather, Graphcast and Fourcastnet for convective available potential energy (CAPE) and storm relative helicity (SRH) at lead times of up to 7 days. Looking at the example of a US tornado outbreak on April 12 and 13, 2020, all models predict elevated CAPE and SRH values multiple days in advance. The spatial structures in the AI-models are smoothed in comparison to IFS and the reanalysis ERA5. The models show differing biases in the prediction of CAPE values, with Graphcast capturing the value distribution the most accurately and Fourcastnet showing a consistent underestimation. By advancing the assessment of large AI-models towards process-based evaluations we lay the foundation for hazard-driven applications of AI-weather-forecasts
Temperature-size responses during ontogeny are independent of progenitors’ thermal environments
Get PDFBackground: Warming generally induces faster developmental and growth rates,
resulting in smaller asymptotic sizes of adults in warmer environments (a pattern
known as the temperature-size rule). However, whether temperature-size responses
are affected across generations, especially when thermal environments differ from
one generation to the next, is unclear. Here, we tested temperature-size responses at
different ontogenetic stages and in two consecutive generations using two soil-living
Collembola species from the family Isotomidae: Folsomia candida (asexual) and
Proisotoma minuta (sexually reproducing).
Methods: We used individuals (progenitors; F0) from cultures maintained during several generations at 15 °C or 20 °C, and exposed their offspring in cohorts (F1) to various thermal environments (15 °C, 20 °C, 25 °C and 30 °C) during their ontogenetic development (from egg laying to first reproduction; i.e., maturity).
We measured development and size traits in the cohorts (egg diameter and body
length at maturity), as well as the egg diameters of their progeny (F2). We predicted
that temperature-size responses would be predominantly determined by
within-generation plasticity, given the quick responsiveness of growth and
developmental rates to changing thermal environments. However, we also expected
that mismatches in thermal environments across generations would constrain
temperature-size responses in offspring, possibly due to transgenerational plasticity.
Results: We found that temperature-size responses were generally weak in the two
Collembola species, both for within- and transgenerational plasticity. However, egg
and juvenile development were especially responsive at higher temperatures and
were slightly affected by transgenerational plasticity. Interestingly, plastic responses
among traits varied non-consistently in both Collembola species, with some traits
showing plastic responses in one species but not in the other and vice versa.
Therefore, our results do not support the view that the mode of reproduction can be
used to explain the degree of phenotypic plasticity at the species level, at least between
the two Collembola species used in our study. Our findings provide evidence for a
general reset of temperature-size responses at the start of each generation and
highlight the importance of measuring multiple traits across ontogenetic stages to
fully understand species’ thermal responses
Co-occurrence of hail and heavy precipitation in Switzerland
Get PDFThe co-occurrence of hail and heavy rainfall has the potential to lead to an increase in damages. For example, a dense cover of hail may clog drainage systems, consequently creating a situation favoring flooding by subsequent rain. In this exploratory study, we investigate this phenomenon of co-occurring precipitation types, first in a case study of the 28th of June 2021 in Switzerland, a day with substantial damages caused by convective storms, before following up with an analysis of the whole convective season of 2021. For the co-occurrence analysis, we require data with high temporal and spatial resolution and good spatial coverage, which is challenging in the complex alpine topography. For both hail and rain, we use datasets produced by the Swiss weather radar network, which consists of f ive c-band radars at altitudes between 900–3000m. Further, the rain dataset is created using rain gauge data to improve the accuracy of the radar-based rain estimates. The case study showed that hail and rainfall co-occurred in large areas, with 88% of the cooccurrence areas experiencing extreme rainfall within 10 minutes of each other. The proximity, large impact area, and high cumulative amount of rainfall after the hail likely contributed to the costly damages of the 28 June 2021 hail event. Further, the seasonal analysis has shown that the cumulative amount of rain after the first hail detection is significantly higher than before. However, these results are not homogeneous in space or time but exhibit regional variation. Additionally, we find that the co-occurrence of hail and rain is impacted by the estimated maximum hail size as well as by the presence of cold fronts. Finally, we also explore the reliability and limitations of using radar data for the estimation of both hail and rain, e.g. addressing the challenge of errors in radar rainfall estimates arising from the presence of hail stones
Ultrathin-strut versus thin-strut stent healing and outcomes in preclinical and clinical subjects.
No full textBACKGROUND
Compared with thin-strut durable-polymer drug-eluting stents (DP-DES), ultrathin-strut biodegradable-polymer sirolimus-eluting stents (BP-SES) improve stent-related clinical outcomes in patients undergoing percutaneous coronary intervention (PCI). Reduced stent strut thickness is hypothesised to underlie these benefits, but this conjecture remains unproven.
AIMS
We aimed to assess the impact of strut thickness on stent healing and clinical outcomes between ultrathin-strut and thin-strut BP-SES.
METHODS
First, we performed a preclinical study of 8 rabbits implanted with non-overlapping thin-strut (diameter/thickness 3.5 mm/80 μm) and ultrathin-strut (diameter/thickness 3.0 mm/60 μm) BP-SES in the infrarenal aorta. On day 7, the rabbits underwent intravascular near-infrared fluorescence optical coherence tomography (NIRF-OCT) molecular-structural imaging of fibrin deposition and stent tissue coverage, followed by histopathological analysis. Second, we conducted an individual data pooled analysis of patients enrolled in the BIOSCIENCE and BIOSTEMI randomised PCI trials treated with ultrathin-strut (n=282) or thin-strut (n=222) BP-SES. The primary endpoint was target lesion failure (TLF) at 1-year follow-up, with a landmark analysis at 30 days.
RESULTS
NIRF-OCT image analyses revealed that ultrathin-strut and thin-strut BP-SES exhibited similar stent fibrin deposition (p=0.49) and percentage of uncovered stent struts (p=0.63). Histopathological assessments corroÂborated these findings. In 504 pooled randomised trial patients, TLF rates were similar for those treated with ultrathin-strut or thin-strut BP-SES at 30-day (2.5% vs 1.8%; p=0.62) and 1-year follow-up (4.3% vs 4.7%; p=0.88).
CONCLUSIONS
Ultrathin-strut and thin-strut BP-SES demonstrate similar early arterial healing profiles and 30-day and 1-year clinical outcomes
Optimal timing of a colonoscopy screening schedule depends on adenoma detection, adenoma risk, adherence to screening and the screening objective: A microsimulation study.
Get PDFColonoscopy-based screening provides protection against colorectal cancer (CRC), but the optimal starting age and time intervals of screening colonoscopies are unknown. We aimed to determine an optimal screening schedule for the US population and its dependencies on the objective of screening (life years gained or incidence, mortality, or cost reduction) and the setting in which screening is performed. We used our established open-source microsimulation model CMOST to calculate optimized colonoscopy schedules with one, two, three or four screening colonoscopies between 20 and 90 years of age. A single screening colonoscopy was most effective in reducing life years lost from CRC when performed at 55 years of age. Two, three and four screening colonoscopy schedules saved a maximum number of life years when performed between 49-64 years; 44-69 years; and 40-72 years; respectively. However, for maximum incidence and mortality reduction, screening colonoscopies needed to be scheduled 4-8 years later in life. The optimum was also influenced by adenoma detection efficiency with lower values for these parameters favoring a later starting age of screening. Low adherence to screening consistently favored a later start and an earlier end of screening. In a personalized approach, optimal screening would start earlier for high-risk patients and later for low-risk individuals. In conclusion, our microsimulation-based approach supports colonoscopy screening schedule between 45 and 75 years of age but the precise timing depends on the objective of screening, as well as assumptions regarding individual CRC risk, efficiency of adenoma detection during colonoscopy and adherence to screening
Innovative Delivery Systems for Curcumin: Exploring Nanosized and Conventional Formulations.
Get PDFCurcumin, a polyphenol with a rich history spanning two centuries, has emerged as a promising therapeutic agent targeting multiple signaling pathways and exhibiting cellular-level activities that contribute to its diverse health benefits. Extensive preclinical and clinical studies have demonstrated its ability to enhance the therapeutic potential of various bioactive compounds. While its reported therapeutic advantages are manifold, predominantly attributed to its antioxidant and anti-inflammatory properties, its efficacy is hindered by poor bioavailability stemming from inadequate absorption, rapid metabolism, and elimination. To address this challenge, nanodelivery systems have emerged as a promising approach, offering enhanced solubility, biocompatibility, and therapeutic effects for curcumin. We have analyzed the knowledge on curcumin nanoencapsulation and its synergistic effects with other compounds, extracted from electronic databases. We discuss the pharmacokinetic profile of curcumin, current advancements in nanoencapsulation techniques, and the combined effects of curcumin with other agents across various disorders. By unifying existing knowledge, this analysis intends to provide insights into the potential of nanoencapsulation technologies to overcome constraints associated with curcumin treatments, emphasizing the importance of combinatorial approaches in improving therapeutic efficacy. Finally, this compilation of study data aims to inform and inspire future research into encapsulating drugs with poor pharmacokinetic characteristics and investigating innovative drug combinations to improve bioavailability and therapeutic outcomes
Analysis of Target Vessel Instability in Fenestrated Endovascular Repair (f-EVAR) in Thoraco-Abdominal Aortic Pathologies.
Get PDFObjective: The aim of this study was to evaluate the influence of target vessel anatomy and post-stenting geometry on the outcome of fenestrated endovascular aortic repair (f-EVAR). Methods: A retrospective review of data from a single center was conducted, including all consecutive fenestrated endovascular aortic repairs (f-EVARs) performed between September 2018 and December 2023 for thoraco-abdominal aortic aneurysms (TAAAs) and complex abdominal aortic aneurysms (cAAAs). The analysis focused on the correlation of target vessel instability to target vessel anatomy and geometry after stenting. The primary endpoint was the cumulative incidence of target vessel instability. Secondary endpoints were the 30-day and follow-up re-interventions. Results: A total of 136 patients underwent f-EVAR with 481 stented target vessels. A total of ten target vessel instabilities occurred including three in visceral and seven instabilities in renal vessels. The cumulative incidence of target vessel instability with death as the competing risk was 1.4%, 1.8% and 3.4% at 1, 2 and 3 years, respectively. In renal target vessels (260/481), a diameter ≤ 4 mm (OR 1.21, 95% CI 1.035-1.274, p = 0.009) and an aortic protrusion ≥ 5.75 mm (OR 8.21, 95% CI 3.150-12-23, p = 0.027) was associated with an increased target vessel instability. In visceral target vessels (221/481), instability was significantly associated with a preoperative tortuosity index ≥ 1.25 (HR 15.19, CI 95% 2.50-17.47, p = 0.045) and an oversizing ratio of ≥1.25 (HR 7.739, CI % 4.756-12.878, p = 0.049). Conclusions: f-EVAR showed favorable mid-term results concerning target vessel instability in the current cohort. A diameter of ≤4 mm and an aortic protrusion of ≥5.75 mm in the renal target vessels as well as a preoperative tortuosity index and an oversizing of the bridging stent of ≥1.25 in the visceral target vessels should be avoided
Data sources:
BORIS Portal Bern Open Repository and I...BAF-Online: Proceedings of the Berner Al...HASBonline – Hefte zur Archäologie des M...Informationswissenschaft: Theorie, Metho...Jahrbuch Diakonie SchweizJournal of Eye Movement ResearchJournal of Radiation Oncology Informatic...BOP SerialsVersants. Revista suiza de literaturas r...BORIS ThesesAccess Repository Dashboard
Do you manage Bern Open Repository and Information System (BORIS)? Access insider analytics, issue reports and manage access to outputs from your repository in the CORE Repository Dashboard!