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Cystic Fibrosis: Clinical Phenotypes in Children and Adolescents
Ana Luiza Melo dos Santos,Helen de Melo Santos,Marina Bettiol Nogueira,Hugo Tadashi Oshiro Távora,Maria de Lourdes Jaborandy Paim da Cunha,Renata Belém Pessoa de Melo Seixas,Luciana de Freitas Velloso 대한소아소화기영양학회 2018 Pediatric gastroenterology, hepatology & nutrition Vol.21 No.4
Purpose: The objective of this study was to describe the clinical phenotypes of children and adolescents with cystic fibrosis (CF); and to assess the role of pancreatic insufficiency and neonatal screening in diagnosis.Methods: A cross-sectional study was conducted, which included 77 patients attending a reference center of CF between 2014 and 2016. Epidemiological data, anthropometric measurements, and the presence of pulmonary, pancreatic, gastrointestinal and hepatobiliary manifestations were evaluated based on clinical data and complementary examinations.Results: Of the 77 patients, 51.9% were male, with a median age of 147 months (7.0-297.0 months), and the majority showed adequate nutritional status. The most common phenotype was pulmonary (92.2%), followed by pancreatic (87.0%), with pancreatic insufficiency in most cases. Gastrointestinal manifestation occurred in 46.8%, with constipation being the more common factor. Hepatobiliary disease occurred in 62.3% of patients. The group with pancreatic insufficiency was diagnosed earlier (5.0 months) when compared to the group with sufficiency (84.0 months) (p=0.01). The age of diagnosis was reduced following implementation of neonatal screening protocols for CF (6.0 months before vs. 3.0 months after, p=0.02).Conclusion: The pulmonary phenotype was the most common, although extrapulmonary manifestations were frequent and clinically relevant, and should mandate early detection and treatment. Neonatal screening for CF led to earlier diagnosis in patients with pancreatic failure, and therefore, should be adopted universally.
Impact of the Fourth Industrial Revolution on the Health Sector: A Qualitative Study
João António Gomes de Melo e Castro e Melo,Nuno Miguel Faria Araújo 대한의료정보학회 2020 Healthcare Informatics Research Vol.26 No.4
Objectives: The Fourth Industrial Revolution is changing the way health is understood, transforming the methods of treatmentand diagnosis as well as the relationship between health professionals and patients and altering the management andorganization of health systems. The main objective of this study was to explore the impact that the Fourth Industrial Revolutionis having on the health sector. Methods: Conducting interviews consisting of four questions with 10 professionals whohad experience working in the health sector to gain their insights and to obtain information to meet the general objective ofthe study as well as its specific objectives. Results: From the analysis of the respondents’ responses, it was possible to createfive dimensions developed by the topics most addressed by respondents, namely, impact on healthcare efficiency and effectiveness,impact on government action, impact on human resources, impact on health system organization, and financialimpact on the health sector. Conclusions: Although the Fourth Industrial Revolution is still at an early stage, it has been concludedthat it is having a major positive impact on the health sector. For the effective and efficient implementation of thesedisruptive technologies, a global interaction between governments, health professionals, stakeholders, and society is essentialto make this change possible.
Cystic Fibrosis: Clinical Phenotypes in Children and Adolescents
dos Santos, Ana Luiza Melo,de Melo Santos, Helen,Nogueira, Marina Bettiol,Tavora, Hugo Tadashi Oshiro,da Cunha, Maria de Lourdes Jaborandy Paim,de Melo Seixas, Renata Belem Pessoa,Monte, Luciana de Fr The Korean Society of Pediatric Gastroenterology 2018 Pediatric gastroenterology, hepatology & nutrition Vol.21 No.4
Purpose: The objective of this study was to describe the clinical phenotypes of children and adolescents with cystic fibrosis (CF); and to assess the role of pancreatic insufficiency and neonatal screening in diagnosis. Methods: A cross-sectional study was conducted, which included 77 patients attending a reference center of CF between 2014 and 2016. Epidemiological data, anthropometric measurements, and the presence of pulmonary, pancreatic, gastrointestinal and hepatobiliary manifestations were evaluated based on clinical data and complementary examinations. Results: Of the 77 patients, 51.9% were male, with a median age of 147 months (7.0-297.0 months), and the majority showed adequate nutritional status. The most common phenotype was pulmonary (92.2%), followed by pancreatic (87.0%), with pancreatic insufficiency in most cases. Gastrointestinal manifestation occurred in 46.8%, with constipation being the more common factor. Hepatobiliary disease occurred in 62.3% of patients. The group with pancreatic insufficiency was diagnosed earlier (5.0 months) when compared to the group with sufficiency (84.0 months) (p=0.01). The age of diagnosis was reduced following implementation of neonatal screening protocols for CF (6.0 months before vs. 3.0 months after, p=0.02). Conclusion: The pulmonary phenotype was the most common, although extrapulmonary manifestations were frequent and clinically relevant, and should mandate early detection and treatment. Neonatal screening for CF led to earlier diagnosis in patients with pancreatic failure, and therefore, should be adopted universally.
Salemi Marianna de Melo,Gomes Vanessa Maria da Silva Alves,Bezerra Laylla Marjorye Rebouças,Melo Thania Maion de Souza,Alencar Geisa Guimarães de,Montenegro Iracema Hermes Pires de Mélo,Calado Alessan 사단법인약침학회 2021 Journal of Acupuncture & Meridian Studies Vol.14 No.6
Background: Cupping therapy is used to treat musculoskeletal conditions, including low back pain. Objectives: The study assessed the effects of dry cupping on pain and functional disability from persistent nonspecific low back pain. Methods: This was a randomized controlled trial, where participants were allocated to a cupping therapy (n = 19) or sham (n = 18) group, for five 10-minute sessions of cupping therapy, twice a week, to stimulate the acupoints related to low back pain (GV4, BL23, BL24, BL25, and BL30, BL40 and BL58) and emotional aspects (HT3 and ST36). All participants were assessed at baseline, post-treatment and follow up (a finalization period of four weeks) using a visual analogue scale (VAS) and the Oswestry Disability Index (ODI). Groups were compared using the analysis of covariance (ANCOVA) and the effect size was calculated using Cohen ̓s d. Results: The cupping therapy group presented a lower mean VAS when compared to the sham, at post-treatment (mean difference: –2.36; standard error [SE]: 0.58; p < 0.001; “large” effect size: –0.94) and follow up (mean difference: –1.71; SE: 0.81; p < 0.042; ‘large’ effect size: –0.83). The cupping therapy group presented a lower mean ODI when compared to the sham post-treatment (mean difference: –4.68; SE: 1.85; p: 0.017; ‘large’ effect size: –0.87), although in follow-up, there was no difference between the groups (mean difference: 4.16; SE: 2.97; p: 0.17; “medium” effect size: –0.70). Conclusion: Dry cupping was more effective in improving pain and functional disability in people with persistent nonspecific low back pain when compared to the sham.
Melo, A.D.B.,Silveira, H.,Luciano, F.B.,Andrade, C.,Costa, L.B.,Rostagno, M.H. Asian Australasian Association of Animal Productio 2016 Animal Bioscience Vol.29 No.1
The intestinal environment plays a critical role in maintaining swine health. Many factors such as diet, microbiota, and host intestinal immune response influence the intestinal environment. Intestinal alkaline phosphatase (IAP) is an important apical brush border enzyme that is influenced by these factors. IAP dephosphorylates bacterial lipopolysaccharides (LPS), unmethylated cytosine-guanosine dinucleotides, and flagellin, reducing bacterial toxicity and consequently regulating toll-like receptors (TLRs) activation and inflammation. It also desphosphorylates extracellular nucleotides such as uridine diphosphate and adenosine triphosphate, consequently reducing inflammation, modulating, and preserving the homeostasis of the intestinal microbiota. The apical localization of IAP on the epithelial surface reveals its role on LPS (from luminal bacteria) detoxification. As the expression of IAP is reported to be downregulated in piglets at weaning, LPS from commensal and pathogenic gram-negative bacteria could increase inflammatory processes by TLR-4 activation, increasing diarrhea events during this phase. Although some studies had reported potential IAP roles to promote gut health, investigations about exogenous IAP effects or feed additives modulating IAP expression and activity yet are necessary. However, we discussed in this paper that the critical assessment reported can suggest that exogenous IAP or feed additives that could increase its expression could show beneficial effects to reduce diarrhea events during the post weaning phase. Therefore, the main goals of this review are to discuss IAP's role in intestinal inflammatory processes and present feed additives used as growth promoters that may modulate IAP expression and activity to promote gut health in piglets.
Correction to: Effect of biosolid hydrochar on toxicity to earthworms and brine shrimp
Melo, Tatiane Medeiros,Bottlinger, Michael,Schulz, Elke,Leandro, Wilson Mozena,de Aguiar Filho, Adelmo Menezes,Ok, Yong Sik,Rinklebe, Jö,rg Springer-Verlag 2018 Environmental geochemistry and health Vol.40 No.1
Plant and soil responses to hydrothermally converted sewage sludge (sewchar)
Melo, Tatiane Medeiros,Bottlinger, Michael,Schulz, Elke,Leandro, Wilson Mozena,Menezes de Aguiar Filho, Adelmo,Wang, Hailong,Ok, Yong Sik,Rinklebe, Jö,rg Elsevier 2018 CHEMOSPHERE - Vol.206 No.-
<P><B>Abstract</B></P> <P>This study compared the effects of sewchar and mineral fertilizer on plant responses in beans (<I>Phaseolus vulgaris</I>, var. “Jalo precoce”) and soil properties in a pot experiment in a completely randomized design with two harvests. The initial treatments consisted of a control, sewchar doses of 4, 8, 16 and 32 Mg ha<SUP>−1</SUP> and mineral fertilizer (30 mg N, 90 mg P<SUB>2</SUB>O<SUB>5</SUB> and 60 mg K<SUB>2</SUB>O kg<SUP>−1</SUP>). The treatments (4 replications each) were fertilized with 135 mg P<SUB>2</SUB>O<SUB>5</SUB> kg<SUP>−1</SUP> at the second harvest. The sewchar application rates correlated positively with the CEC, the water holding capacity, the availability of Zn, Ca, Fe, Cu, and P, and the concentrations of nitrate, ammonium, total N, total organic carbon and hot water extractable carbon. They correlated negatively with the Mg availability and the soil C: N ratio. Additionally, they correlated positively with the P, Zn and Ca uptake from the soil. For both harvests, the 16 Mg ha<SUP>−1</SUP> sewchar treatment had a total dry matter equivalent to that of the mineral fertilizer. After the second harvest, the 16 Mg ha<SUP>−1</SUP> sewchar treatment revealed 96% higher plant biomass than the control and 79% higher biomass than it did during the first period. The positive effect of sewchar in addition to phosphorous on the plant response and soil properties suggests that the residual effect of sewchar could be a promising alternative as a soil amendment for partly replacing mineral fertilizers. In future, further studies are necessary to evaluate long-term residual effects of sewchar in soil.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Mineral fertilizer had higher total dry matter in the first harvest. </LI> <LI> The 16 Mg ha<SUP>−1</SUP> sewchar dose had total dry matter equivalent to mineral fertilizer. </LI> <LI> Increasing sewchar doses correlated positively with P, Zn and Ca plant uptake. </LI> <LI> Sewchar doses had higher total dry matter average in the second harvest. </LI> </UL> </P> <P><B>Graphical abstract</B></P> <P>[DISPLAY OMISSION]</P>
Price and Quality Effects of VERs Revisited : A Case Study of Korean Footwear Exports
Melo, Jaime de,Winters, L, Alan 세종대학교 국제경제연구소 1993 Journal of Economic Integration Vol.8 No.1
This paper analyzes the price and quality effects of VERs on Korean footwear exports, applying index numbers to disaggregated Korean footwear exports during the period 1974-86. Unlike previous studies of upgrading that have relied on analyses of imports to the restricted markets, this paper compares restrained exporter's sales to different markets, thereby providing a more accurate test of theoretical predictions. We find significant price increases to the restricted markets and mild across the board downgrading during the period when the VERs were binding.