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Trends in the global, regional, and national burden of oral conditions from 1990 to 2021: a systematic analysis for the Global Burden of Disease Study 2021
Get PDFMilyen gyermeknek lenni a V4-államokban? Tanulságok a Gyermekjogi Bizottság záró észrevételei alapján
No full textKisér-vasculitisek a gyakorlatban [Small vessel vasculitides in the daily practice ]
No full textA kisér-vasculitisek jellemzôen súlyos, ér -fali és szöveti necrosist, gyakran életveszélyes szervi károsodást okozó immunmediált betegségek. Klinikailag a leggyakoribbtünetek a rapidan progrediáló glomerulonephritis, az akut interstitialis pneumonia,a purpura, illetve nekrotizáló bôrvasculitis,a mononeuritis multiplex, valamint gastrointestinalis, szemészeti vagy fül-orr-gégészeti nekrotizáló gyulladásos folyamatok. Aprimer kisér-vasculitisek szisztémás autoim -mun betegségek, két fô csoportjuk az antineutrofil citoplazmatikus antitest (ANCA-)asszociált, valamint az immunkomplexvasculitisek. Emellett számos malignus, fertôzéses, gyógyszeres vagy egyéb eredetûbetegség is okozhat szisztémás vasculitisestüneteket, melyek a szekunder kisér-vasculitisek csoportját képezik. A primer kisérvasculitisek terápiájának alapkövei a nagyadag kortikoszteroid-, ciklofoszfamid-, rituximab-, esetenként plazmaferézis-kezelések, és az intenzív indukciós immunszuppressziót jellemzôen fenntartó immunmoduláns kezelés követi. A gondozás során arelapsusok megelôzését és az irreverzibilisszervi károsodások progressziójának elkerülését kell elsôsorban szem elôtt tartani
Enhancing design skills in art and design education
Get PDFIntroduction: In art and design education, design-based learning (DBL) is crucial for students’ design skills enhancement. Moreover, students’ motivation plays a
significant role in their creative performance in design education. Therefore, this study aimed to explore the impact of students’ DBL and motivation on their
design skills development in art and design education.
Methods: Notably, 207 University students participated in the current experimental research. With the help of nonrandom sampling, the experimental group (102) and the control group (105) were divided. The experimental group was given the treatment with DBL and the control group with the traditional
instructions.
Results and discussion: The findings showed that experimental students who were treated by the DBL performed better in design skills assessment than
those who were given traditional instructions. However, no gender difference was found in the analysis of covariance in the design skills assessment.
Students’ motivation, such as intrinsic motivation, achievement motivation, and failure-avoidance motivation also have significant impacts on their design skills
development. These research findings encouraged educators to be able to use the DBL technique in their design skills instructions
Eligibility for rapid up-titration of guideline-directed medical therapy of real-world patients hospitalised for heart failure
Get PDFIntroduction and aims: The 2023 Focused Update of the 2021 ESC Heart Failure (HF) Guidelines recommends the rapid up-titration (RT) of guideline-directed medical therapy (GDMT) for all patients hospitalised for HF to improve prognosis in light of STRONG-HF trial. However, the real-world feasibility of RT and the optimal selection of suitable patients may cause difficulties, as the STRONG-HF trial applied strict randomisation criteria. We aimed to assess the proportion of hospitalised HF patients suitable for RT after discharge.Methods: The proportion of patients eligible for RT based on the basic in- and exclusion criteria of the STRONG-HF trial (systolic blood pressure [SBP]≥100mmHg, heart rate [HR]≥60min-1, serum potassium≤5mmol/L, eGFR≥30mL/min/1.73m2, discharge NT-proBNP>1500pg/mL) was assessed in a consecutive patient cohort at a tertiary referral center between 01/04/2021 and 31/12/2023. Results: Data from 408 consecutive patients were analysed (male: 71%; age: 62[51-72]years; left ventricular ejection fraction: 27[20-35]%; HFrEF: 82%; hypertension: 67%; diabetes: 36%; atrial fibrillation: 47%). 78% of the patients were suitable for RT based on the SBP criterion, 93% on HR, 89% on serum potassium, and 91% on eGFR values. Thus, 60% were eligible for RT using the combined assessment of these parameters. When including the NT-proBNP value as well (60%), 34% of the cohort were eligible for RT.Conclusions: Based on our study, the proportion of patients suitable for RT of GDMT ranged from 34% to 60% based on the basic eligibility indicators of the STRONG-HF trial. Our results highlight the strategic importance of careful selection of patients eligible for RT
Gastric adenocarcinoma with enteroblastic differentiation : [case report]
Get PDFIntroduction: Gastric adenocarcinoma with enteroblastic differentiation (GAED) is a rare entity with worse prognosis compared to conventional gastric adenocarcinomas. Its histological characteristics are fetal gut-like architecture and tumor cells with cytoplasmic clearing, as well as positive immunohistochemical reaction to at least one of the enteroblastic markers. Hereby, we present a case of GAED with neuroendocrine marker positivity, with whole exome sequencing (WES), and an updated literature review.Case presentation: A 68-year-old woman presented with abdominal pain. Gastric wall thickening raised suspicion of gastric cancer, thus gastroscopy was performed, and biopsy samples were taken, which confirmed malignancy. Neoadjuvant systemic chemotherapy was initiated, and total gastrectomy was performed. Microscopically, pleomorphic polygonal cells were visible with clear cytoplasm and high grade cellular atypia. Alcian blue and PAS stains demonstrated positivity for acidic and neutral mucins. P53 IHC was negative, indicative of null-phenotype, while Syntaxin-1 and Chromogranin showed focal positivity. SALL4 and Glypican 3 were positive, however, AFP displayed only minimal, uncertain positivity. The Ki67 labeling index was 70%. Due to the morphological and immunohistochemical characteristics, the tumor was concluded as GAED with neuroendocrine marker positivity. WES was carried out revealing 4 pathogenic, including TP53, KLHL7, RAPSN, and ACTA1, and 3 likely pathogenic mutations, encompassing PNKP, HNF1A, and ADNP.Discussion: GAED is a rare subtype of gastric adenocarcinomas, representing 0.3-5.4% of all cases and has an unclarified etiology. Our WES results identified new pathogenic and likely pathogenic mutations. From a differential diagnostic point of view, hepatoid adenocarcinoma, and the possibility of metastatic origin has to be excluded
Valorization of Glycerol to Glycerol Carbonate and Glycidol by Different Dialkyl Carbonates Utilizing Tricalcium Aluminate Hexahydrate as Transesterification Catalyst
Get PDFHerein, we report a base‐catalyzed transesterification reaction of glycerol, a waste product of the biodiesel industry, with various dialkyl carbonates, which act both as reactants and solvents, to convert glycerol carbonate into an industrially useful molecular building block. The catalyst, being used for the first time, is also a waste product from industry, present in bauxite residues and in the Portland cement, simply known as tricalcium aluminate. Despite being well‐known and readily available, this solid is only extremely poorly researched catalyst, nevertheless, using dimethyl and diethyl carbonate, glycerol conversion rates >80% and glycerol carbonate yields >60% could be achieved in just 1 hour (under air atmosphere, and reflux). In a comparison of the performance with other catalysts commonly researched today, as well as with other components of red mud and cements, the results showed that tricalcium aluminate is excellent, cheap and largely environmentally friendly material for this purpose. Reusability studies of the catalysts have also shown that they provide high conversion and product yields even after repeated use, although different material characterization techniques showed intense glycerol‐catalyst surface interaction and intermediate product formation, the deactivating side effects of which could be avoided by catalyst regeneration steps
Ten-Year Results After Canaloplasty and Phacocanaloplasty
Get PDFBackground/Objectives: To evaluate the long-term efficacy and safety of canaloplasty and phacocanaloplasty in patients with primary open-angle glaucoma (POAG) and pseudoexfoliation glaucoma (PEXG). Methods: This retrospective observational study included 85 patients with POAG and PEXG who underwent canaloplasty (group 1) or phacocanaloplasty (group 2). Every patient had complete medical records over a 10-year follow-up period. The primary endpoints were the pressure-lowering and drug-sparing effects. The secondary endpoints were intra- and postoperative complications as well as the need for additional surgical interventions. Results: In group 1, the mean baseline intraocular pressure (IOP) of 22.1 ± 0.9 mmHg was reduced to 15.3 ± 0.5 mmHg, 15.7 ± 0.5 mmHg, and 15.9 ± 0.7 mmHg at 1, 5, and 10 years, respectively. The mean medication use decreased from 2.4 ± 1.0 before surgery to 0.1 ± 0.5, 0.8 ± 1.1, and 1.4 ± 1.3 at 1,5, and 10 years, respectively. In group 2, IOP was reduced from 20.4 ± 1.5 to 15.6 ± 1.0, 14.3 ± 0.8, and 14.2 ± 1.2 at 1, 5, and 10 years, respectively. The mean medication use dropped from 2.4 ± 1 to 0.3 ± 0.9, 0.9 ± 1.4, and 0.8 ± 1.1 at 1,5, and 10 years, respectively. Goniopuncture was performed postoperatively in nine cases (13.9%) within the initial 3 months due to IOP spikes (POAG n = 6, PEXG n = 3). Patients with PEXG had a significantly higher likelihood of requiring re-operation (HR = 5.11, HR = 5.11, 95% CI 1.05–24.74, p = 0.043). No serious complications were observed. Conclusions: Canaloplasty is a safe and effective procedure for lowering IOP in eyes with POAG and PEXG, achieving approximately a 30% reduction in IOP. PEXG patients are likelier to have IOP spikes in the late postoperative period therefore careful monitoring and management is required
