876 research outputs found
How university students perceive different learning techniques: a study in Spain and Italy
No full textThe purpose of this paper is to provide insights on different learning techniques from the perspective
of university students. Upon group discussions conducted with students, 12 learning techniques were
identified, which can be gathered in the following four groups: 1) classroom-based learning (learning
from theoretical and practical classes, learning from academic and professional guest lecturers,
learning from case studies and real-life examples), 2) outdoor learning (learning outside the classroom
and firm visits), 3) collaborative learning (group work and intercultural teams) and 4) technology-based
learning (e-learning and m-learning). These techniques were assessed then among 309 students of
Faculty of Economics from two European universities: University of Valencia in Spain (N=158) and
Sapienza University of Rome in Italy (N=151). The fieldwork was conducted at the end of 2017 and
beginning of 2018. Results show that learning from real-life examples and practical classes emerged
as favourite techniques, followed by learning through firm visits and learning from professional guest
lecturers. Instead, learning from theoretical classes, academic guest lectures, and technology-based
learning (both e-learning and m-learning) were the lowest scored methods. Several significant
differences were obtained when perceptions of students from the Spanish and Italian university were
compared, especially in the case of outdoor learning and most of the classroom-based learning
techniques. Technology-based learning practices did not show any significant difference between the
two examined groups
Evaluation of adenosine deaminase seric activity in the diagnosis of bovine tuberculosis
No full textDetermination of seric levels of adenosine deaminase (ADA), an enzyme produced by monocytes/macrophages and lymphocytes, has been used in the diagnosis of human tuberculosis (TB). In the present study, ADA seric activity was evaluated comparatively to the comparative tuberculin test in the diagnosis of bovine tuberculosis. Two hundred fifty-six cattle were classified by origin and by the comparative tuberculin test as TB-positive animals (n = 52, from herds where the Mycobacterium bovis had previously been isolated), and TB-negative animals (n = 204, TB-free herds). The mean ADA seric value from the TB-positive group (4.45 ± 2.33 U/L) was significantly lower (p = 0.008) than that observed in sera from the TB-negative group (6.12 ± 4.47 U/L). When animals from a herd with clinical cases of enzootic bovine leukosis of TB-negative group were withdrawn from analysis, the mean ADA seric values of TB-negative group (5.12 ± 3.75 U/L) was not significantly different anymore from that of the TB-positive group (p = 0.28). There was no agreement in the diagnosis of bovine TB between comparative tuberculin test and determination of ADA seric values, using two different cutoff points, being 6.12 U/L and 15.0 U/L, (kappa = -0.086 and kappa = -0.082, respectively). In conclusion, the determination of ADA seric activity was not a good auxiliary test for bovine TB, because it was not able to distinguish between TB-positive and TB-negative animals
Intravenous thrombolysis versus endovascular thrombectomy in acute basilar artery occlusion—A multicenter cohort study
No full textBackground: Randomized controlled trials have demonstrated an improved outcome of basilar artery occlusion (BAO) with endovascular thrombectomy (EVT) compared to best medical treatment. However, a minority of the patients recruited up to 12–24 h from onset in the positive trials received intravenous thrombolysis (IVT), and a trial with a higher IVT rate did not show superiority of EVT. Thus, the efficacy and safety of EVT compared to IVT for BAO remain less clear. Aims: We aimed to compare outcomes after IVT alone to EVT with or without IVT for acute BAO. Methods: This international, observational, retrospective study included patients who received recanalization therapy for BAO at six centers between January 2010 and March 2024. The primary outcome was 3-month modified Rankin Scale (mRS) score 0–3, and secondary outcomes comprised mRS 0–2, ordinal mRS, mortality, and symptomatic intracranial hemorrhage. Outcomes after IVT versus EVT ± IVT were compared using inverse probability-weighted regression adjustment models adjusting for known predictors of outcome in BAO and baseline variables differing between the treatment groups. Interaction of the treatment group with symptom severity and onset-to-treatment time was tested. Results: Of 523 patients with BAO (median age 69, 35.2% women), 28.9% received IVT and 71.1% EVT ± IVT. The IVT-alone group had a lower baseline National Institutes of Health Stroke Scale score (median 11 vs 15) but equally extensive ischemic changes in baseline imaging. After inverse probability-weighted regression adjustment, the IVT-alone group had higher odds of mRS 0–3 (adjusted odds ratio (aOR) = 2.33 [95% confidence interval (CI) = 1.31–4.12]), mRS 0–2 (aOR = 1.93 [95% CI = 1.12–3.30]), lower median mRS (aOR = 1.81 [95% CI = 1.21–2.71]), and lower mortality (aOR = 0.53 [95% CI = 0.29–0.97]), but no difference in symptomatic intracranial hemorrhage (aOR = 0.81 [95% CI = 0.28–2.36]). No interactions for the primary outcome were found. Conclusion: In this study, patients with BAO had better outcome after IVT than EVT ± IVT independent of symptom severity and time from onset. Although the non-randomized design of the study warrants caution, the results encourage further trials comparing EVT and IVT to guide recanalization therapy in BAO patients. Data access statement: Anonymized data are available upon reasonable request to the corresponding author following the national legislation.Peer reviewe
Remote ischaemic conditioning improves outcomes of ischaemic stroke treated by endovascular thrombectomy: the SERIC-EVT trial
No full textBACKGROUND AND AIMS: Even after endovascular thrombectomy, more than half of patients with acute large vessel occlusion stroke do not achieve favourable outcomes. This study aimed to assess the efficacy and safety of remote ischaemic conditioning (RIC), a promising neuroprotective treatment, in patients with acute ischaemic stroke who received endovascular thrombectomy. METHODS: This participant-blinded, randomized controlled clinical trial was conducted at 25 hospitals. Patients were randomized 1:1 to either the RIC (cuff pressure, 200 mmHg; twice daily for 7 days) or sham RIC (60 mmHg; same procedure) groups. The primary outcome was the proportion of patients with a modified Rankin Scale score of 0-2 on Day 90. The primary safety outcome was the proportion of patients with haemorrhagic transformation within 7 days. RESULTS: In total, 498 participants were recruited. Ten patients (2.0%) were excluded because they did not receive any intervention. Thus, 488 participants (244 in the RIC group and 244 in the sham RIC group) were included in the modified intention-to-treat analysis. At 90 days, 61.1% of the patients in the RIC group and 48.9% in the sham RIC group achieved a modified Rankin Scale score of 0-2 (unadjusted risk ratio 1.25, 95% confidence interval 1.06-1.47; P = .009). The proportion of patients with haemorrhagic transformation was 37.7% and 35.2% in the RIC and sham RIC groups, respectively. CONCLUSIONS: Among patients with acute ischaemic stroke who underwent endovascular thrombectomy, intervention with RIC for 7 days, compared with sham RIC, resulted in an improved functional outcome at 90 days
Portfolio optimization through hybrid deep learning and genetic algorithms vine Copula-GARCH-EVT-CVaR model
No full textInternational audienceThis study investigates the potential benefits of using the Conditional Value at Risk (CVaR) portfolio optimization approach with a GARCH model, Extreme Value Theory (EVT), and Vine Copula to obtain the optimal allocation decision for a portfolio consisting of Bitcoin, gold, oil, and stock indices. First, we fit a suitable GARCH model to the return series for each asset, followed by employing the Generalized Pareto Distribution (GPD) to model the innovation tails. Next, we construct a Vine Copula-GARCH-EVT model to capture the interdependence structure between the assets. To refine risk assessment, we combine our model with a Monte Carlo simulation and Mean-CVaR model to optimize the portfolio. In addition, we utilize a novel version of deep machine learning's genetic algorithm to address the optimization decision. This research contributes new evidence to the CVaR portfolio optimization approach and provides insights for portfolio managers seeking to optimize multi-asset portfolios
Comparative outcomes of aortobifemoral bypass with or without previous endovascular kissing stenting of the aortoiliac bifurcation
No full textObjective: The aim of this multicenter national study was to compare the outcomes of primary open surgery by aorto-bifemoral bypass (ABFB) with those performed after a failed endovascular treatment (EVT) by kissing stent technique for complex aortoiliac occlusive disease (AIOD) lesions (TransAtlantic Inter-Society Consensus [TASC] II C and D). Methods: All consecutive ABFB cases carried out at 12 vascular surgery centers between 2016 and 2021 were retrospectively collected and analyzed. Data included patients’ baseline demographics and clinical characteristics, procedural details, perioperative outcomes, and follow-up results (survival, patency, amputation). The study cohort was divided into two groups based on indications for ABFB: primary treatment vs secondary treatment after EVT failure. Results: Overall, 329 patients underwent ABFB during the study period (71% males; mean age, 64 years), of which 285 were primary treatment and 44 were after prior EVT. At baseline, no significant differences were found between study groups in demographics and clinical characteristics. TASC C and D lesions were similarly represented in the study groups (TASC C: 22% vs 78%; TASC D: 16% vs 84%). No major differences were found between study groups in terms of procedural details, early mortality, and perioperative complications. At 5 years, primary patency rates were significantly higher for primary ABFB (88%; 95% confidence interval [CI], 93.2%-84%) as compared with ABFB after prior EVT (69%; 95% CI 84.9%-55%; log rank P value <.001); however, the 5-year rates of secondary patency (100% vs 95%; 95% CI, 100%-86%) and limb salvage (97%; 95% CI, 99%-96 vs 97%; 95% CI, 100%-94%) were similar between study groups. Conclusions: Surgical treatment of TASC C/D AIOD with ABFB seems to be equally safe and effective when performed after prior EVT, although primary ABFB seemed to have higher primary patency rates. Despite the need for more frequent reinterventions, secondary patency and limb salvage rates were similar. However, future large prospective trials are required to confirm these findings
Nivelul seric al zincului la copiii cu glomerulonefrită
No full text”Nicolae Testemiţanu” State University of Medicine and Pharmacy, Department of Pediatrics,
IMSP Mother and Child InstituteThe paper presents a study on serum zinc levels of 80 children with glomerulonephritis (GN) at different clinical
stages of disease development. During the acute phase of clinical manifestations, in patients with steroid-sensitive
nephrotic syndrome (SSNS), serum zinc (Zn) level signifi cantly decreased by 2,8 times, and in steroid-resistant
nephrotic syndrome (SRNS) - by 3,4 times, compared to the control group. In remission serum Zn level was increased
as compared to the initial level, but was still reduced as compared to the control group.Determination of serum Zn
levels could be used to monitor the activity of a pathological process in children with various variants of GN and to
assess the effectiveness of therapeutic measures.Была изучена концентрация цинка (Zn) в крови у 80 детей с гломерулонефритом (ГН) в различные клинические
стадии заболевания. В острой фазе клинических проявлений у больных с стероидувствительным
нефротическим синдромом (СЧНС) уровень Zn в крови достоверно снижается в 2,8 раза, а при стероидрезистентном нефротическом синдроме (СРНС) - в 3,4 раза. В период ремиссии уровень Zn в крови повышается
по сравнению с исходным уровнем, но остается сниженным по сравнению с контрольной группой. Определение
концентрации Zn в крови может быть использовано для мониторинга активности патологического процесса у
детей с различными вариантами ГН, и контроля эффективности лечебных мероприятий.Lucrarea prezintă un studiu efectuat pe un lot de 80 de copii cu glomerulonefrită (GN) la diferite etape clinicoevolutive
ale maladiei, cu determinarea nivelului de zinc (Zn) seric. S-a stabilit că la pacienții cu sindrom nefrotic
steroid-sensibil (SNSS), în perioada acutizării, nivelul Zn seric se reduce semnificativ ‒ de 2,8 ori, iar în sindromul
nefrotic steroid-rezistent (SNSR) ‒ de 3,4 ori, comparativ cu grupul de control. În perioada de remisiune, nivelul Zn
seric a crescut, comparativ cu nivelul inițial, dar a rămas mai redus, comparativ cu grupul de control. Determinarea
nivelului de Zn seric este o metodă ce poate fi utilizată pentru monitorizarea activității procesului patologic la copii cu
diverse variante ale GN, precum și pentru evaluarea eficacității tratamentului
Comparative outcomes of aortobifemoral bypass with or without previous endovascular kissing stenting of the aortoiliac bifurcation
No full textObjective: The aim of this multicenter national study was to compare the outcomes of primary open surgery by aorto-bifemoral bypass (ABFB) with those performed after a failed endovascular treatment (EVT) by kissing stent technique for complex aortoiliac occlusive disease (AIOD) lesions (TransAtlantic Inter-Society Consensus [TASC] II C and D).
Methods: All consecutive ABFB cases carried out at 12 vascular surgery centers between 2016 and 2021 were retrospectively collected and analyzed. Data included patients' baseline demographics and clinical characteristics, procedural details, perioperative outcomes, and follow-up results (survival, patency, amputation). The study cohort was divided into two groups based on indications for ABFB: primary treatment vs secondary treatment after EVT failure.
Results: Overall, 329 patients underwent ABFB during the study period (71% males; mean age, 64 years), of which 285 were primary treatment and 44 were after prior EVT. At baseline, no significant differences were found between study groups in demographics and clinical characteristics. TASC C and D lesions were similarly represented in the study groups (TASC C: 22% vs 78%; TASC D: 16% vs 84%). No major differences were found between study groups in terms of procedural details, early mortality, and perioperative complications. At 5 years, primary patency rates were significantly higher for primary ABFB (88%; 95% confidence interval [CI], 93.2%-84%) as compared with ABFB after prior EVT (69%; 95% CI 84.9%-55%; log rank P value < .001); however, the 5-year rates of secondary patency (100% vs 95%; 95% CI, 100%-86%) and limb salvage (97%; 95% CI, 99%-96 vs 97%; 95% CI, 100%-94%) were similar between study groups.
Conclusions: Surgical treatment of TASC C/D AIOD with ABFB seems to be equally safe and effective when performed after prior EVT, although primary ABFB seemed to have higher primary patency rates. Despite the need for more frequent reinterventions, secondary patency and limb salvage rates were similar. However, future large prospective trials are required to confirm these findings
Combining Tibial Cortex Transverse Transport (TTT) and Endovascular Therapy (EVT) for Limb Salvage in Chronic Limb‐Threatening Ischemia
No full textObjective The clinical management of patients with chronic limb‐threatening ischemia (CLTI) faces great challenges. Enhancing wound healing and limb preservation rates in this cohort is a critical objective. This study investigates the effectiveness of combining tibial cortex transverse transport (TTT) and endovascular therapy (EVT) for the treatment of patients with severe CLTI. We aim to evaluate the therapeutic results of this combined approach on the specified patient group. Methods We conducted a retrospective study to compare EVT with the combination of TTT and EVT in patients (Rutherford category 5 and above) with CLTI at Guangxi Medical University's First Affiliated Hospital from June 2017 to June 2023. This cohort was subjected to a follow‐up period ranging from a minimum of 6 months to a maximum of 12 months. The primary outcome measures included amputation‐free survival (AFS) (avoidance of above‐ankle amputation or death from any cause), overall mortality, limb salvage rates, wound healing efficiency, and the technical efficacy of the applied treatments. A variety of statistical analyses including chi‐square tests, Fisher's exact tests, and Pearson's and Spearman's correlation analyses. Results In this study, 131 patients with CLTI were included: 76 in the control group receiving only EVT treatment and 55 in the TTT + EVT group. The two groups were matched on demographic and clinical characteristics. In the TTT + EVT group, after more than 6 months of follow‐up, 85.5% of patients achieved AFS, and wound healing was observed in 54.5% (30 of 55 patients). After more than 12 months of follow‐up, 81.9% achieved AFS, with wound healing in 32 patients. Furthermore, after more than 24 months, 74.2% of patients remained amputation‐free, with wound healing in all surviving patients. In the control group, after more than 6 months of follow‐up, 72.4% of patients achieved AFS, and wound healing was observed in 51.3% (39 of 96 patients). After more than 12 months, 48.9% achieved AFS, with wound healing in 21 patients. Conclusion We found that combining therapy of TTT and EVT is safe and can be successfully administered in patients with CLTI and it enhances wound healing and AFS
Total flavonoids from Semen Cuscutae target MMP9 and promote invasion of EVT cells via Notch/AKT/MAPK signaling pathways
No full textMiscarriage is a common condition during pregnancy and its mechanisms remain largely unknown. Extravillous trophoblast (EVT) cell invasion is required to maintain normal pregnancy and its malfunction has been proposed as a major cause for miscarriage. Homeostasis of matrix metalloproteinase 9 (MMP9) is a key to regulate EVT cell invasion. Total flavonoids from Semen Cuscutae (TFSC) have been applied clinically used for preventing or treating miscarriage in the past. Given its potential clinical benefit on preventing miscarriage, this study aims at examining the therapeutic effect of TFSC in the prevention of premature birth by upregulating MMP9 and promote EVT cell invasion. HTR-8 cells migration and invasion functions were analyzed using wound healing and transwell assays. The regulatory effect of TFSC on MMP9 expression and relevant signaling pathways were analyzed by Western Blot. The results show compared to control group, TFSC significantly promoted the migration of EVT cells in a dose and time-dependent manner. The migration and invasion of EVT cells were maximized at the highest dosage of 5 μg/ml of TFSC. The expression of MMP9 in EVT cells was significantly increased after TFSC treatment. Furthermore, cells treated with TFSC significantly upregulated protein expressions in Notch, AKT and p38/MAPK signaling pathways. We believe TFSC can promote the migration and invasion of EVT cells by increasing MMP9 expression, and prevent miscarriage by activating Notch, AKT, and MAPK signaling pathways.</p
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