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Obesity and Stroke: Does the Paradox Apply for Stroke?
Quiñones-Ossa Gabriel A,Lobo Carolina,Garcia-Ballestas Ezequiel,Florez William A,Moscote-Salazar Luis Rafael,Agrawal Amit 대한신경중재치료의학회 2021 Neurointervention Vol.16 No.1
Historically, obesity has been identified as one of the most important risk factors for developing cardiovascular diseases including stroke; however, a theory called “The Obesity Paradox” has been recently considered. The paradoxical theory is that obese or overweight patients (according to body mass index score) can have better outcomes compared to leaner or malnourished patients. The paradox was initially discovered in patients with heart failure. The purpose of this manuscript was to investigate whether this paradox also applies to stroke patients, according to information available in the current literature.
William A Florez,Ezequiel Garcia-Ballestas,Gabriel Alexander Quiñones-Ossa,Tariq Janjua,Subhas Konar,Amit Agrawal,Luis Rafael Moscote-Salazar 대한신경중재치료의학회 2021 Neurointervention Vol.16 No.3
Flow diverters have become a critical instrument for complex aneurysms treatment. However, limited data are currently available regarding short and long-term outcomes for the Silk flow diverter. The objective of the study is to determine neurological prognosis and mortality rates for the Silk flow diversion device used in intracranial aneurysms. A systematic review with meta-analysis was performed using databases. The following descriptors were used for the search: “SILK”, “Flow Diverter”, “Mortality”, and “Prognosis”. The following data were extracted: mortality, good functional outcome, Glasgow outcome scale, complete or near-complete occlusion rates, rate of retreatment, and complications (thromboembolic and hemorrhagic complications). A total of 14 studies were selected. Among the 14 studies, 13 were retrospective observational cohort studies and 1 was a prospective observational cohort study. The mortality rate was 2.84%. The clinical good outcomes rate was 93.3%. The poor outcome rate was 6.6%. The overall thromboembolic complication rate was 6.06% (95% confidence interval [CI] 0.00–6.37, P=0.12, I2=3.13%). The total hemorrhagic complication rate was 1.62% (95% CI 0.00–5.34, P=0.28, I2=1.56%). The complete aneurysm occlusion rate was 80.4% (95% CI 8.65–9.38, P<0.0001, I2=9.09%). The Silk diverter device has a good safety and efficacy profile for treating intracranial aneurysms with high complete occlusion rates.
Use of supercritical methanol/carbon dioxide mixtures for biodiesel production
María Belén García-Jarana,Jezabel Sánchez-Oneto,Juan Ramón Portela,Lourdes Casas,Casimiro Mantell,Enrique Martínez de la Ossa 한국화학공학회 2016 Korean Journal of Chemical Engineering Vol.33 No.8
The use of supercritical conditions for the production of biodiesel from both vegetables oils and waste-oils may be of great industrial interest because it can be carried out without those catalysts necessary in the conventional transesterification process, therefore avoiding a complex separation between the product and the catalyst. However, the use of supercritical alcohol requires higher operating temperatures and pressures. In this work, CO2 was added to the reaction mixture in order to reduce the operating conditions (temperature, pressure and molar ratio of alcohol to vegetable oil). The novelty of using CO2 may have two advantages: a possible combination of supercritical CO2 extraction of the oil and its subsequent transesterification reaction without CO2 depressurization, and a reduction of the supercritical temperature and pressure of the mixture. The effects of temperature (280-350 oC), pressure (140-280 bar), methanol- to-oil molar ratio (20-30), CO2-to-methanol molar ratio (0.05-0.2) and residence time (0-45minutes) on the yield of methyl esters (biodiesel) were studied in a batch reactor, obtaining in all cases a relatively low increase in the yield when CO2 was present in the medium. The yields of biodiesel were tested with three vegetable oils used as model compounds (palm, sunflower and borage), obtaining similar results.
Escobar-Correa, Natalia,Ramirez-Bustamante, Maria Antonia,Sanchez-Uribe, Luis Alejandro,Upegui-Zea, Juan Carlos,Vergara-Villarreal, Patricia,Ramirez-Ossa, Diana Milena The Korean Association Of Orthodontists 2021 대한치과교정학회지 Vol.51 No.1
Objective: To evaluate the mandibular buccal shelf (MBS) in terms of the angulation and bone depth and thickness according to sex, age, and sagittal and vertical skeletal patterns in a Colombian population using cone-beam computed tomography (CBCT). Accordingly, the optimal site for miniscrew insertion in this area was determined. Methods: This descriptive, retrospective study included 64 hemi-arches of 34 patients. On CBCT images, the angulation, buccal bone depth (4 and 6 mm from the cementoenamel junction [CEJ] of MBS), and buccal bone thickness (6 and 11 mm from the CEJ of MBS) were measured at the mesial and distal roots of the mandibular first and second molars. Results: There were no statistically significant differences in the angulation, depth, and thickness of MBS between male and female patients. The values for the bone around the distal root of the mandibular second molar were significantly greater than the other values. The osseous characteristics were significantly better in participants aged 16-24 years. Class III patients exhibited the best osseous characteristics, with the bone depth at 6 mm being significantly different from that in Class I and Class II patients. Although values tended to be greater in patients with low angles, the difference was not statistically significant. Conclusions: MBS provides an optimal bone surface for miniscrew insertion, with better osseous characteristics at the distal root of the mandibular second molar, 4 mm from CEJ. Adolescent patients, Class III patients, and patients with a low angle exhibit the most favorable osseous characteristics in the MBS area.
Antonio Montes,Chandrasekar Chinnarasu,Clara Pereyra,Lourdes Casas,María Teresa Fernández-Ponce,Casimiro Mantell,Sangma Pattabhi,Enrique Martínez de la Ossa 한국화학공학회 2016 Korean Journal of Chemical Engineering Vol.33 No.2
Various extracts from olive leaves have been precipitated by a supercritical antisolvent (SAS) process to evaluate the possibility of producing polyphenol fine particles with controlled size and size distribution. Olive leaves were initially extracted with subcritical fluids using mixtures of CO2+ethanol at 10% and 50%, by pressurized liquid extraction (PLE) with water, ethanol and a hydroalcoholic mixture (50 : 50) (v/v), and also by conventional ethanol extraction (CE). PLE gave the extract with the highest yield and the best antioxidant activity. SAS precipitation was unsuccessful for the extracts obtained with pressurized water and with the hydroalcoholic mixture (50 : 50) (v/v). The SAS precipitates with the smallest particle sizes were produced from extracts obtained with subcritical fluids. The SAS precipitates obtained after the conventional ethanol extraction of olive leaves showed the best antioxidant activity.
Frailty-Independent Undertreatment Negative Impact on Survival in Older Patients With Breast Cancer
Fernando Osório,António S. Barros,Bárbara Peleteiro,Ana Rita Barradas,Joana Urbano,José Luís Fougo,Adelino Leite-Moreira 한국유방암학회 2021 Journal of breast cancer Vol.24 No.6
Purpose: The management of older adults with breast cancer (BC) remains controversial. The challenging assessment of aging idiosyncrasies and the scarce evidence of therapeutic guidelines can lead to undertreatment. Our goal was to measure undertreatment and assess its impact on survival. Methods: Consecutive patients with BC aged 70 years or older were prospectively enrolled in 2014. Three frailty screening tools (G8, fTRST, and GFI) and two functional status scales (Karnofsky performance score and Eastern Cooperative Oncology Group Performance Status) were applied. Disease characteristics, treatment options, and causes of mortality were recorded during a 5-year follow-up. In addition, we defined undertreatment and correlated its survival impact with frailty. Results: A total of 92 patients were included in the study. The median age was 77 (range 70–94) years. The prevalence of frailty was discordant (G8, 41.9%; fTRST, 74.2%; GFI, 32.3%). Only 47.8% of the patients had a local disease, probably due to a late diagnosis (73.9% based on self-examination). Thirty-three patients (35.6%) died, of which 15 were from BC. We found a considerably high proportion (53.3%) of undertreatment, which had a frailty-independent negative impact on the 5-year survival (hazard ratio [HR], 5.1; 95% confidence interval [CI], 2.1–12.5). Additionally, omission of surgery had a frailty-independent negative impact on overall survival (HR, 3.9; 95% CI, 1.9–7.9). Conclusion: BC treatment in older adults should be individualized. More importantly, assessing frailty (not to treat) is essential to be aware of the risk-benefit profile and the patient's well-informed willingness to be treated. Undertreatment in daily practice is frequent and might have a negative impact on survival, as we report.
Nathalia Del Rio Lyra Graça,Anna Rebeca de Barros Lins Silva Palmeira,Luana Osório Fernandes,Marlus da Silva Pedrosa,Renata Pedrosa Guimarães,Saulo Cabral dos Santos,Anderson Stevens Leonidas Gomes,Cl 대한영상치의학회 2019 Imaging Science in Dentistry Vol.49 No.2
The available methods for veneer evaluation are limited to clinical and radiographic examinations, which may not allow the appropriate identification of failure. In this report, we demonstrate the use of optical coherence tomography (OCT) as a noninvasive diagnostic and follow-up method to evaluate gingival recovery and the adhesive interface in aesthetic oral rehabilitation involving periodontal plastic surgery and ceramic laminate veneers. OCT was efficient for evaluating both soft and hard tissues, as well as the quality of the adhesive interface. In conclusion, OCT was found to be a promising approach for the professional evaluation of aesthetic oral rehabilitation, as it was capable of generating images that enabled the analysis of gingival recovery and the adhesive interface.
How to Train Philosophical Counselors
Ora Gruengard 강원대학교 인문과학연구소 2018 Journal of Humanities Therapy Vol.9 No.2
I explain my conception of philosophical experience and, on the basis of a proposed distinction between levels of philosophy, I deal with its place, in philosophical counseling and its importance in the training of counselees. My criteria for counseling that is really philosophical are, however, not only the level of the philosophical background of the counselor and the philosophical quality of the dialogues, but also the sincerity and moral responsibility that may justify the trust of a counselee in a philosophical counselor.