Objective
This exploratory pilot study aimed to investigate the physical and mental disease burden of unaccompanied asylum‐seeking adolescents arriving in Bielefeld, a medium‐size city in Germany.
...Methods
A cross‐sectional survey with purposive sampling of 102 unaccompanied asylum‐seeking adolescents aged 12–18 years was performed. Information on general health status, selected infectious and non‐communicable diseases, iron deficiency anaemia and mental illness was collected during routine check‐up medical examinations upon arrival in Bielefeld, Germany. The data were analysed using descriptive statistics.
Results
The analysis revealed a complex disease burden with a high prevalence of infections (58.8%), mental illness (13.7%) and iron deficiency anaemia (17.6%) and a very low prevalence of non‐communicable diseases (<2.0%). One in five of the refugees were infected with parasites. Whilst sub‐Saharan Africans showed the highest prevalence of infections (86.7%), including highest prevalences of parasites (46.7%), West Asians had the highest prevalence of mental disorders (20.0%). Overall, the disease burden in females was higher.
Conclusion
A thorough medical and psychological screening after arrival is highly recommended to reduce the individual disease burden and the risk of infection for others. This promotes good physical and mental health, which is needed for successful integration into the receiving society. Barriers to health service access for unaccompanied asylum‐seeking adolescents need to be lowered to allow need‐specific health care and prevention.
Objectif
Cette étude pilote exploratoire visait à étudier la charge de morbidité physique et mentale des adolescents demandeurs d'asile non accompagnés arrivant à Bielefeld, une ville de taille moyenne en Allemagne.
Méthodes
Une enquête transversale avec un échantillonnage raisonné de 102 adolescents demandeurs d'asile non accompagnés, âgés de 12 à 18 ans a été effectuée. Les informations sur l’état général de santé, de maladies infectieuses et non transmissibles sélectionnées, l'anémie ferriprive et la maladie mentale ont été recueillies au cours d'examens médicaux de routine à l'arrivée à Bielefeld, en Allemagne. Les données ont été analysées à l'aide de statistiques descriptives.
Résultats
L'analyse a révélé une charge de morbidité complexe avec une forte prévalence des infections (58,8%), de la maladie mentale (13,7%) et de l'anémie ferriprive (17,6%) et une très faible prévalence des maladies non transmissibles (<2,0%). Un sur cinq de ces réfugiés était infecté par des parasites. Alors que les ressortants d'Afrique subsaharienne montraient la plus forte prévalence des infections (86,7%), y compris les prévalences les plus élevées en parasites (46,7%), ceux d'Asie de l'ouest avaient la plus forte prévalence des troubles mentaux (20,0%). Globalement, la charge de morbidité chez les femmes était plus élevée.
Conclusion
Un examen médical et psychologique approfondie après l'arrivée est fortement recommandé afin de réduire la charge des maladies individuelles et le risque d'infection pour les autres. Cela favorise une bonne santé physique et mentale, qui est nécessaire pour une intégration réussie dans la société d'accueil. Les obstacles à l'accès aux services de santé pour les adolescents demandeurs d'asile non accompagnés devraient être retirés pour permettre des soins et la prévention en santé nécessaires et spécifiques.
Objetivo
En este estudio piloto exploratorio se investiga la carga de enfermedad física y mental de adolescentes no acompañados que buscan asilo en Bielefeld, una ciudad de tamaño medio en Alemania.
Métodos
Estudio crosseccional con muestreo intencional de 102 adolescentes no acompañados que buscan asilo, con edades entre 12–18 años. Se recogió información sobre su estatus de salud general, ciertas enfermedades infecciosas y no infecciosas, anemia con deficiencia de hierro y enfermedad mental durante una revisión médica rutinaria al llegar a Bielefeld, Alemania. Los datos se analizaron utilizando estadísticas descriptivas.
Resultados
Los análisis revelaron una carga de enfermedad compleja con una alta prevalencia de infecciones (58.8%), enfermedad mental (13.7%) y anemia ferropénica (17.6%) y una muy baja prevalencia de enfermedades no infecciosas (<2.0%). Uno de cada cinco refugiados estaba infectado con parásitos. Mientras que los Africanos subsaharianos tenían la más alta prevalencia de infecciones (86.7%), incluyendo la prevalencia más alta de parásitos (46.7%), los asiáticos del oeste tenían la mayor prevalencia de enfermedades mentales (20.0%). En general, la carga de enfermedad en mujeres era mayor.
Conclusión
Se recomienda una revisión médica y psicológica completa después de la llegada, para reducir la carga de enfermedad individual y el riesgo de infección para otros. Ello promueve una buena salud física y mental, necesarias para una integración exitosa en la sociedad de acogida. Deben disminuirse las barreras de acceso a los servicios sanitarios para los adolescentes sin compañía y en busca de asilo, de forma que puedan tener una atención sanitaria específica y preventiva.
Genetic abnormalities are a hallmark of cancer. Hereby, cytogenetic aberrations and small-scale abnormalities, such as single-nucleotide variations and insertion/deletion mutations, have emerged as ...two alternative modes of genetic diversification. Both mechanisms are at work in acute myeloid leukemia (AML), in which conventional karyotyping and molecular studies demonstrate that gene mutations occur predominantly in cytogenetically normal AML, whereas chromosomal changes are a driving force of development and progression of disease in aberrant karyotype AML. All steps of disease evolution in AML, ranging from the transformation of preleukemic clones into overt leukemia to the expansion and recurrence of malignant clones, are paralleled by clonal evolution at either the gene mutation or chromosome aberration level. Preleukemic conditions, such as Fanconi anemia and Bloom syndrome, demonstrate that the acquisition of chromosomal aberrations can contribute to leukemic transformation. Similar to what has been shown at the mutational level, expansion and recurrence of AML clones goes along with increasing genetic diversification. Hereby, cytogenetically more evolved subclones are at a proliferative advantage and outgrow ancestor clones or have evolved toward a more aggressive behavior with additional newly acquired aberrations as compared with the initial leukemic clone, respectively.
•This ESMO Clinical Practice Guideline provides key recommendations for managing cancer of unknown primary (CUP).•The guideline covers CUP diagnosis, risk assessment, classification, treatment and ...follow-up.•Differential diagnostic algorithms for discrimination between CUP and other cancers are provided.•The author group includes multidisciplinary experts from different institutions in Europe, Australia and the United States.•Recommendations are based on available scientific data and the authors’ collective expert opinion.•In clinical practice, all recommendations provided need to be discussed with patients in a shared decision-making approach.
Insulin Storage: A Critical Reappraisal Heinemann, Lutz; Braune, Katarina; Carter, Alan ...
Journal of Diabetes Science and Technology,
01/2021, Letnik:
15, Številka:
1
Book Review, Journal Article
Recenzirano
Odprti dostop
Insulin, as a peptide hormone drug, is susceptible to changes in stability when exposed to environmental factors under storage. Proper storage according to the manufacturer’s recommendations is ...important to maintain its potency and enable precise dosing for people with diabetes (PwD). While it is reasonable to assume that transport conditions and temperature are well controlled during the supply chain, little is known about insulin storage after dispensing and insulin potency at the moment of administration. Insulin is exposed to various environmental factors when carried by PwD and storage recommendations are often not met when it is stored in household refrigerators. It is difficult to assess changes in insulin potency in clinical practice, and there is a gap in the current scientific literature on insulin stability. Package leaflet recommendations only give limited information on the impact of improper storage conditions on insulin stability and guidelines by health organizations are inconsistent. Given the importance of precise dosing in diabetes care, there is a need for more transparency on insulin stability, awareness for proper storage among health care professionals and PwD as well as clear guidelines and practical storage recommendations from manufacturers and health organizations.
Rolling is a well-established forming process employed in many industrial sectors. Although highly optimized, process disruptions can still lead to undesired final mechanical properties. This paper ...demonstrates advances in pass schedule design based on reinforcement learning and analytical rolling models to guarantee sound product quality. Integrating an established physical strengthening model into an analytical rolling model allows tracking the microstructure evolution throughout the process, and furthermore the prediction of the yield strength and ultimate tensile strength of the rolled sheet. The trained reinforcement learning algorithm Deep Deterministic Policy Gradient (DDPG) automatically proposes pass schedules by drawing upon established scheduling rules combined with novel rule sets to maximize the final mechanical properties. The designed pass schedule is trialed using a laboratory rolling mill while the predicted properties are confirmed using micrographs and materials testing. Due to its fast calculation time, prospectively this technique can be extended to also account for significant process disruptions such as longer inter-pass times by adapting the pass schedule online to still reach the desired mechanical properties and avoid scrapping of the material.
Neomorphic mutations in isocitrate dehydrogenase 1 (IDH1) are frequently found in several human cancer types including acute myeloid leukemia (AML) and lead to the production of high levels of the ...oncometabolite (R)-2-hydroxyglutarate (R-2HG). Here we report the characterization of BAY1436032, a novel pan-mutant IDH1 inhibitor, both in vitro and in vivo. BAY1436032 specifically inhibits R-2HG production and colony growth, and induces myeloid differentiation of AML cells carrying IDH1R132H, IDH1R132C, IDH1R132G, IDH1R132L and IDH1R132S mutations. In addition, the compound impacts on DNA methylation and attenuates histone hypermethylation. Oral administration of BAY1436032 led to leukemic blast clearance, myeloid differentiation, depletion of leukemic stem cells and prolonged survival in two independent patient-derived xenograft IDH1 mutant AML mouse models. Together, BAY1436032 is highly effective against all major types of IDH1 mutant AML.
Centrosome amplification is a frequent phenomenon in malignancies and may facilitate tumorigenesis by promoting chromosomal instability. On the other hand, a centrosome inactivation checkpoint ...comprising centrosome amplification leading to elimination of cells by mitotic catastrophe has been described in response to DNA damage by ionizing radiation or cytostatic drugs. So far, the exact nature of DNA damage-induced centrosome amplification, which might be overduplication or fragmentation of existing centrosomes, has been controversial. To solve this controversy, we have established a method to distinguish between these two possibilities using A549 cells expressing photoconvertible CETN2-Dendra2. In response to various DNA-damaging treatments, centrosome amplification but not fragmentation was observed. Moreover, centrosome amplification was preceded by excessive formation of centrin-containing centriolar satellites, which were identified as de novo-generated atypical centrin dots staining positive for centriolar satellite markers but negative or only weakly positive for other established centrosomal markers, and which could be verified as centriolar satellites using immunogold electron microscopy. In line with this notion, disruption of dynein-mediated recruitment of centrosomal proteins via centriolar satellites suppressed centrosome amplification after DNA damage, and excessive formation of centriolar satellites could be inhibited by interference with Chk1, a known mediator of centrosome amplification in response to DNA damage. In conclusion, we provide a model in which a Chk1-mediated DNA damage checkpoint induces excessive formation of centriolar satellites constituting assembly platforms for centrosomal proteins, which subsequently leads to centrosome amplification.
Laser sources with wavelengths in the visible blue spectrum are suitable for heat conduction mode welding of materials like copper and nickel due to the significantly increased Fresnel absorption ...compared to infrared laser radiation. Recently, blue laser sources with 445 nm wavelength have become available with sufficient power and beam parameters to exceed the intensity threshold for laser deep penetration welding. In laser beam deep penetration welding, the total absorption is significantly increased due to the multiple reflections in the keyhole compared to heat conduction mode welding. However, since the absorbed energy per reflection inside the keyhole is wavelength-dependent, it can be hypothesized that the choice of laser wavelength causes changes in the local energy distribution inside the keyhole, changing the keyhole dynamics. To investigate this, laser beam deep penetration welding experiments were carried out on 2.4068 pure nickel using an infrared laser source and a blue laser source with comparable beam properties. The experiments were monitored and compared by a multi-sensor setup and metallographic analyses. This setup included measurements of airborne acoustic emissions and two high-speed video cameras for spatter tracking and tracking of the keyhole area. The use of a blue laser beam led to a lower spatter quantity, an increase of porosity and a significant change of acoustic emissions, proving the hypothesis for pure nickel.
B cells undergo several rounds of selection to eliminate potentially pathogenic autoreactive clones, but in contrast to T cells, evidence of positive selection of autoreactive B cells remains moot. ...Using unique tetramers, we traced natural autoreactive B cells (C1-B) specific for a defined triple-helical epitope on collagen type-II (COL2), constituting a sizeable fraction of the physiological B cell repertoire in mice, rats, and humans. Adoptive transfer of C1-B suppressed arthritis independently of IL10, separating them from IL10-secreting regulatory B cells. Single-cell sequencing revealed an antigen processing and presentation signature, including induced expression of CD72 and CCR7 as surface markers. C1-B presented COL2 to T cells and induced the expansion of regulatory T cells in a contact-dependent manner. CD72 blockade impeded this effect suggesting a new downstream suppressor mechanism that regulates antigen-specific T cell tolerization. Thus, our results indicate that autoreactive antigen-specific naïve B cells tolerize infiltrating T cells against self-antigens to impede the development of tissue-specific autoimmune inflammation.
The mechanism governing the impact of the mass isotope on plasma confinement is still one of the main scientific conundrums facing the magnetic fusion community after more than thirty years of ...intense research. We have investigated the properties of local turbulence and long-range correlations in hydrogen and deuterium plasmas in the TEXTOR tokamak. Experimental findings have shown a systematic increasing in the amplitude of long-range correlations during the transition from hydrogen to deuterium dominated plasmas. These results provide the first direct experimental evidence of the importance of multiscale physics for unraveling the physics of the isotope effect in fusion plasmas.
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