De luxuria propagata romana aetate . Roman luxury in
its many forms focuses on luxonomics, or the economy of luxury
in Roman times, and how its study is an element that is essential
to understanding ...the history of the period. This volume brings
together the contributions of leading experts in the study of
luxury to present the full range of perspectives on the production
and consumption of luxury items and, moreover, from the variety of
approaches offered by Ancient History. The book is organised in
chronological order, and the evolution of the luxury economy is
divided into areas of consumption, production, and criticism. The
analytical focus on the interaction between the notions of need and
desire suggests that the historical development of luxury and
business in Rome can be divided into five categories: houses,
clothing, jewellery, food, and leisure.El libro reúne las
contribuciones de los principales expertos en el estudio del lujo
para presentar toda la gama de perspectivas sobre la producción y
consumo de artículos de lujo y, además, desde la variedad de
enfoques que ofrece la Historia Antigua. El libro está organizado
en orden cronológico, y la evolución de la economía del lujo se
divide en áreas de consumo, producción y crítica. El enfoque
analítico en la interacción entre los nociones de necesidad y deseo
sugiere que el desarrollo histórico del lujo y los negocios en Roma
puede dividirse en cinco categorías: casas, ropa, joyas, comida y
ocio.
Emerging 5G wireless technology will support services and use cases with vastly heterogeneous requirements. Network slicing, which allows composing multiple dedicated logical networks with specific ...functionality running on top of a common infrastructure, is introduced as a solution to cope with this heterogeneity. At the radio access network (RAN), the use of network slicing involves the assignment of radio resources to each slice in accordance with its expected requirements and functionalities. Therefore, RAN slicing will provide the required design flexibility and will be necessary for any network slicing solution. This paper investigates the RAN slicing problem for providing two generic services of 5G, namely enhanced mobile broadband (eMBB) and vehicle-to-everything (V2X). In this respect, we propose an efficient RAN slicing scheme based on an off-line reinforcement learning followed by a low-complexity heuristic algorithm, which allocates radio resources to different slices with the target of maximizing the resource utilization while ensuring the availability of resources to fulfill the requirements of the traffic of each RAN slice. A simulation-based analysis is presented to assess the performance of the proposed solution. The simulation results have shown that the proposed algorithm improves the network performance in terms of resource utilization, the latency of V2X services, achievable data rate, and outage probability.
The COVID-19 pandemic called for drastic changes to expand and rapidly implement telehealth to prevent breach of care for chronic patients. Responding to the challenge of implementing remote care in ...chronic pain services, a specialty highly dependent on doctor-patient rapport, physical examination, and frequent follow-up visits requires extensive adaptation involving administrative processes and clinical routines. We present our experience of a successful rapid adaptation to telemedicine paradigm as a response to the COVID-19 pandemic during a time of marked restriction of access to ambulatory hospital services for pediatric and adult chronic pain patients. This narrative review covers current scientific evidence for the use of telehealth for chronic pain management and describes in detail the challenges to implement telemedicine in ambulatory clinics from different perspectives. Best practices for telehealth use are recommended. A proposal for remote physical examination of pain patients is made, based on available evidence in the fields of musculoskeletal medicine and neurology comparing in-person vs remote physical examination. As an internal quality control process, an informal online survey was conducted to assess thoughts and experiences among patients and caregivers using telemedicine consultation services at the pediatric pain clinic. Providing chronic pain management services through telehealth is a viable option for many patients and health care professionals. This is reliant on the availability of appropriate materials and training, with guidelines for both patients and health care workers. With the rapid pace of technological advancements, even further integration of telehealth into routine health care is possible.
Isoprenoids are a large family of compounds synthesized by all free-living organisms. In most bacteria, the common precursors of all isoprenoids are produced by the MEP (methylerythritol 4-phosphate) ...pathway. The MEP pathway is absent from archaea, fungi and animals (including humans), which synthesize their isoprenoid precursors using the completely unrelated MVA (mevalonate) pathway. Because the MEP pathway is essential in most bacterial pathogens (as well as in the malaria parasites), it has been proposed as a promising new target for the development of novel anti-infective agents. However, bacteria show a remarkable plasticity for isoprenoid biosynthesis that should be taken into account when targeting this metabolic pathway for the development of new antibiotics. For example, a few bacteria use the MVA pathway instead of the MEP pathway, whereas others possess the two full pathways, and some parasitic strains lack both the MVA and the MEP pathways (probably because they obtain their isoprenoids from host cells). Moreover, alternative enzymes and metabolic intermediates to those of the canonical MVA or MEP pathways exist in some organisms. Recent work has also shown that resistance to a block of the first steps of the MEP pathway can easily be developed because several enzymes unrelated to isoprenoid biosynthesis can produce pathway intermediates upon spontaneous mutations. In the present review, we discuss the major advances in our knowledge of the biochemical toolbox exploited by bacteria to synthesize the universal precursors for their essential isoprenoids.
Purpose:
To demonstrate that the augmented reality-assisted puncture technique improves the efficacy of ultrasound-guided puncture to get central venous access (CVA), allows the image to be obtained ...without limitations, freeing the hands and keeping the gaze continuously on the working field, which contributes to improving the safety of the procedure.
Material and methods:
A gelatin mould with a latex surface and a chicken breast with silicone tubes inside were used to simulate vascular punctures. Images were obtained by an ultrasound scanner and post-processed with a specific software. A hologram was obtained and projected onto the previously delimited surface to be punctured. The variables related to image acquisition, the characteristics of the structure to be cannulated and the percentage of successes in the first attempt were analysed. Six operators were involved, using different ultrasound scanners. Efficiency was examined after the application of technical improvements in the process.
Results:
Seventy-six punctures were performed, guided by two different ultrasound scanners, divided into two groups: 37 with 33 successes (sigma = 3.52 with a process efficiency of 97.98%) and after technical improvements, 39 with 38 successes (sigma = 4.07 with a process efficiency of 99.4%). There are no significant differences among the operators (X2 p = 0.47) and between the ultrasound scanners (X2 p = 0.56).
Conclusions:
The augmented reality ultrasound-assisted CVA technique may be the next step in standardising the process of cannulation of vascular structures. This technique provides greater accuracy, greater comfort by freeing the hands and keeping the gaze on the working field, better ultrasound image quality, and eliminates variability between operators and sonographers.
To present unprecedented radiological parameters that characterize the angle between the direct and indirect tendons of the proximal rectus femoris (RF) and its inclinations and to evaluate the ...population variability according to demographic variables.
From September 2019 to July 2021, using MRI multiplanar reconstructions of the proximal thigh/hip, two blinded radiologists measured the direct and indirect tendon angle and the inclination of each tendon in different planes. The intra- and inter-observer agreements were assessed with Bland-Altman analysis and intraclass correlation coefficient (ICC). The correlations between radiological parameters and demographic variables were evaluated using linear regression, Student's
test, and analysis of variance.
We performed 112 thigh/hip MRI scans on 91 football players of different age, gender, and disciplines (football and futsal). For observer 1 (the reference), the mean direct and indirect tendon angle was 56.74° ± 9.37, the mean indirect tendon slope was -7.90° ± 7.49, and the mean direct tendon slope was 22.16° ± 5.88. The three measurements showed inter- and intra-observer agreement (mean differences ∼0). No correlation was observed between age and the parameters. Likewise, no statistically significant differences were found for gender, dominant limb, examined limb, and sport.
There is an inter- and intra-observer agreement in the measurements of the direct and indirect tendon angle and the inclination of each tendon. There is population variability in the proximal tendinous complex unrelated to demographic factors. These results allow further detection of morphological patterns that represent a risk factor for lesions in the RF in professional football and futsal players and other sports.
Abstract Background and purpose Idiopathic inflammatory myopathies (IIM) are systemic diseases, characterized by the presence of an inflammatory muscle infiltrate. Although more frequent in women, ...its relationship with pregnancy has not been extensively studied. Our goal was to analyze the interaction between pregnancy and myositis in a cohort of IIM women from a single center. Methods A total of 51 patients from a historical cohort of IIM diagnosed between 1983 and 2013 were interviewed with a specific questionnaire. Comparisons between pregnancies occurring before and after the onset of the disease were performed using generalized mixed-effect models with normal and binomial distributions adjusted for confounding factors and clustering. Results A total of 102 pregnancies from 51 patients (41 with dermatomyositis and 10 with polymyositis) were analyzed. A total of 14 pregnancies from 8 patients occurred after disease onset; statistically significant ( p = 0.02) clinical improvement during gestation was evident in 7 pregnancies (4 patients), 5 of them (from 2 patients) experienced a relapse of IIM symptoms afterwards, while in the rest, there was no influence of pregnancy on the disease. No disease flare associated with pregnancy was observed. Two patients were diagnosed within the first 6 months after delivery and none during pregnancy. No evidence was found to support pregnancy as a trigger for myopathy ( p = 0.71). Conclusions Pregnancy does not seem to carry a worse prognosis for the mother nor for the fetus in patients with IIM; on the contrary, nearly half of the patients in our series improved clinically when they became pregnant, a relapse of IIM symptoms being common afterwards. Pregnancy does not appear to be a trigger for IIM.
Purpose
This study aims to analyze the factors related to the failure of 535 Federal Deposit Insurance Corporation (FDIC)-Insured United States banks in conjunction with the 2008 financial crisis.
...Design/methodology/approach
The research consists of an analysis of the following three five-year partitions: pre-crisis (2002–2006), crisis (2007–2011) and post-crisis (2012–2016). The main hypothesis is that the factors explaining bank failures vary by period. Using logistic regression analysis, the authors identify the desirable models by period based on three model selection strategies.
Findings
Liquidity and non-risk-based capital ratios are important explanatory factors in all three periods. As the authors can see from the results, when comparing the full period (2002–2016) and the three five-year period partitions (2002–2006, 2007–2011 and 2012–2016), the ratios change from period to period, but they measure the same financial areas of concern in different contexts as follows: liquidity, leverage/risk exposure and capital adequacy. Risk-based capital ratios are not effective predictors of bank failures.
Originality/value
Recent academic studies have analyzed bank failures during periods that cover the years before, during and after the crisis, but most of these studies discuss bank failures in the forecasting context only. This study includes an analysis of failure determinants during pre-crisis, crisis and post-crisis subperiods based on the FDIC monitoring system of bank failures and identifies what ratios are more relevant during each period and how they change from period to period.
A preliminary exploratory study shows solid agreement between the results of case reports and clinical study meta-analyses in mucopolysaccharidosis Type I (MPS-I) adult patients. The aim of the ...present study is to confirm previous results in another patient population, suffering from mucopolysaccharidosis Type II (MPS-II).
A systematic review and meta-analysis of case reports published by April 2018 was conducted for MPS-II patients treated with enzyme replacement therapy (ERT). The study is reported in accordance with PRISMA and MOOSE guidelines (PROSPERO database code CRD42018093408). The assessed population and outcomes were the same as previously analyzed in a meta-analysis of MPS-II clinical studies. The primary endpoint was the percent of clinical cases showing improvement in efficacy outcome, or no harm in safety outcome after ERT initiation. A restrictive procedure to aggregate case reports, by selecting standardized and well-defined outcomes, was proposed. Different sensitivity analyses were able to evaluate the robustness of results.
Every outcome classified as "acceptable evidence group" in our case report meta-analysis had been graded as "moderate strength of evidence" in the aforementioned meta-analysis of clinical studies. Sensitivity, specificity, and positive-negative predictive values for results of both meta-analyses reached 100%, and were deemed equivalent.
Aggregating case reports quantitatively, rather than analyzing them qualitatively, may improve conclusions in rare diseases and personalized medicine. Additionally, we propose some methods to evaluate publication bias and heterogeneity of the included studies in a meta-analysis of case reports.
Abstract The methylerythritol phosphate (MEP) pathway is responsible for biosynthesis of the precursors of isoprenoid compounds in eubacteria and plastids. It is a metabolic alternative to the ...well-known mevalonate pathway for isoprenoid production found in archaea and eukaryotes. Recently, a role for the MEP pathway in oxidative stress detection, signalling, and response has been identified. This role is executed in part through the unusual cyclic intermediate, methylerythritol cyclodiphosphate (MEcDP). We postulate that this response is triggered through the oxygen sensitivity of the MEP pathway’s terminal iron-sulfur (Fe-S) cluster enzymes. MEcDP is the substrate of IspG, the first Fe-S cluster enzyme in the pathway; it accumulates under oxidative stress conditions and acts as a signalling molecule. It may also act as an antioxidant. Furthermore, evidence is emerging for a broader and highly nuanced role of the MEP pathway in oxidative stress responses, implemented through a complex system of differential regulation and sensitivity at numerous nodes in the pathway. Here, we explore the evidence for such a role (including the contribution of the Fe-S cluster enzymes and different pathway metabolites, especially MEcDP), the evolutionary implications, and the many questions remaining about the behaviour of the MEP pathway in the presence of oxidative stress.
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