The sensitivity difference was 18.5% at maximum. Furthermore, when the additional dose was displayed, the influence of noise on long-term measurement was considerable. Using the Kaiser method to obtain the detection limit, the accuracy of the integrated dose had SOF dosimeter error rates of 4.3% to 15.5% with respect to the integrated value of the RPLG dosimeter when calibrated by the ionization chamber dosimeter. The use of the SOF dosimeter allowed for the real-time visualization of the exposure status of the eye lens and measurements with a relatively high accuracy. The purpose of this study was to improve the accuracy of dose-distribution calculations by understanding how the calculated dose varies with the change in the relative electron density replacing polymethyl methacrylate (PMMA) in patient-specific quality assurance. We calculated the relative electron density at which dose attenuation in each dose calculation algorithm coincides with the measured value of the dose attenuation of single-field irradiation. Next, the dose change was calculated by changing the relative electron density or physical electron density for substituting PMMA for each X-ray energy and calculation algorithm. Furthermore, using clinical plans, changes in point-dose verification and dose-distribution verification that occurred when the relative electron density or physical electron density was varied were investigated. The dose attenuation varies depending on the dose-calculation algorithm, and the optimum value of the electron density is different for each. After the electron density optimization, the point dose verification using the 97.1% to 98.3% (3%/3 mm), 90.0% to 94.3% (2%/3 mm) and gained a dominant improvement tendency (P<0.001). We clarified dose change accompanying relative electron density or physical electron density change. We concluded that the accuracy of dose-distribution calculation for verification improves by replacing PMMA with optimal relative electron density or physical electron density. We clarified dose change accompanying relative electron density or physical electron density change. We concluded that the accuracy of dose-distribution calculation for verification improves by replacing PMMA with optimal relative electron density or physical electron density. To compare the radiation dose and image quality using the conventional method for performing the front and side scout view and a new method for performing the side scout view, and then correct the table height at the scan isocenter and perform the front scout view. We retrospectively analyzed fifty-six children who had underwent computed tomography (CT) examination between June 2014 and August 2018. We divided them into two groups. The conventional method was performed in 3 steps 1. obtain the front scout view, 2. obtain the side scout view, and 3. main scan. Without table position correction, the new method was performed in 4 steps 1. obtain the side scout view with table position correction, 2. patient correction at the scan isocenter, 3. obtain the front scout view, and 4. main scan. We used a 64-row CT scanner (LightSpeed VCT; GE Healthcare). Scan parameters were tube voltage 80 kV, automatic tube current modulation, noise index 16, slice thickness 5 mm, rotation time 0.4 s/rot, helical pitch 1.375, ahis potential new method (1. obtain the side scout view, 2. patient correction at the scan isocenter, 3. obtain the side scout view, and 4. main scan). This phantom study aimed to determine the optimal acquisition window size for phase-based respiratory gating in silicon photomultiplier (SiPM)-based fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) and its acquisition time in respiratory-gated imaging with the optimal window size. Images of a moving NEMA IEC Body Phantom Set with hot spheres were acquired. First, the tumor volume and the maximum standardized uptake value (SUV ) of images reconstructed using a different window size were evaluated to define the optimal window size. Second, the quality of the images reconstructed using the optimal window size and different acquisition times was evaluated using the detectability score of the 10-mm hot sphere and physical indices. The volume and the SUV of the 10-mm hot sphere were improved when the window size was narrow, and there were no significant differences among images reconstructed using a window size narrower than 20%. To reconstruct an image using the 20% window size, an acquisition time of 5 min was required to visualize the 10-mm hot sphere. The optimal window size for phase-based respiratory gating is 20%. Further, an acquisition time of 5 min should be taken for respiratory-gated imaging with the 20% window size on SiPM-based FDG-PET/CT. The optimal window size for phase-based respiratory gating is 20%. https://www.selleckchem.com/products/AdipoRon.html Further, an acquisition time of 5 min should be taken for respiratory-gated imaging with the 20% window size on SiPM-based FDG-PET/CT.The purpose of this study was to investigate the trends of researches regarding radiological technology. We collected research papers published from 2007 to 2017 from Japanese Society of Radiological Technology (JSRT). After preprocessing, we performed morphological analysis using terminology from Japan Radiological Society, Japan Society of Medical Physics, and JSRT to extract technical terms. Furthermore, we calculated the Jaccard similarity coefficient to represent the similarity between two terms. This value ranged from 0 to 1, where 0 implied that the terms were completely dissimilar. Finally, in order to detect terms that characteristically appear in each year, we visualized co-occurring terms by using network diagrams. From the morphological analysis, 5471 technical terms were extracted. The most frequency term was "image" from 2007 to 2017. "Phantom" and "CT" were frequent terms after "image." In addition, the number of research papers including "image," "phantom," and "CT" were increasing. For network analysis, the characteristic terms in 2007 were "filter" and "HU"; those in 2012 were "dimension," "standard deviation,"and "artifact"; and those in 2017 were "PET," "scattered ray," and "collimator." In conclusion, the highest interest research topic in radiological technology was "image," and recently, there has been a tendency to be interested in topics related to nuclear medicine.

9% vs. 70.1% for CIN2+,  < 0.001), a comparable sensitivity to "HPV with HPV16/18 reflex cytology ≥ASCUS" (81.9% vs. 81.3% for CIN2+,  > 0.05), and resulted in a slightly lower specificity than the latter two algorithms (92.6% vs. 97.4% and 95.4% respectively for CIN2+,  < 0.05). However, algorithm G achieved a comparable sensitivity to HPV testing alone for CIN3+, and reduced the colposcopy referral rate from 13.7% for HPV testing alone to 8.4%. HPV viral loads reflected by Ct-values are associated with the severity of cervical lesions. Ct-values with an appropriate cut-off of 33.7, combined with HPV16/18 genotyping, represent a promising triage of HPV-positive women particularly for self-collected samples. HPV viral loads reflected by Ct-values are associated with the severity of cervical lesions. Ct-values with an appropriate cut-off of 33.7, combined with HPV16/18 genotyping, represent a promising triage of HPV-positive women particularly for self-collected samples.Cancer stem cells, a special subgroup of cancer cells, have self-renewal capabilities and multidirectional potential, which may be reprogrammed from the dedifferentiation of cancer cells, contributing to the failure of clinical treatments. Esophageal adenocarcinoma grows in an inflammatory environment stimulated by deoxycholic acid, an important component of gastroesophageal reflux content, contributing to the transformation of esophageal squamous epithelium to the precancerous lesions of esophageal adenocarcinoma, that is, Barrett esophagus. In the present study, deoxycholic acid was used to investigate whether it could induce the expression of reprogramming factors Krüppel-like factor, OCT4, and Nanog; the transformation to cancer stem cells in esophageal adenocarcinoma; and the involvement of the interleukin-6/signal transduction and activation of transcription 3 inflammatory signaling pathway. OE33 cells were treated with deoxycholic acid (250 μM) for 0 hour, 3 hours, 6 hours, and 12 hours before evaluatiem cells, improving the antiapoptotic ability of tumors, and increasing the malignancy of esophageal adenocarcinoma. Deactivating the regulatory signaling pathway of interleukin-6/signal transduction and activation of transcription 3 and neutralizing deoxycholic acid may be novel targets for improving the clinical efficacy of esophageal adenocarcinoma therapy.Hypoxia-inducible factor-prolyl hydroxylase inhibitors (HIF-PHIs) are orally active first-in-class new generation drugs for renal anemia. This extensive meta-analysis of randomized controlled trials (RCTs) was designed to provide clear information on the efficacy and safety of HIF-PHIs on anemia in chronic kidney disease (CKD) patients. Searches included PubMed, Web of Science, Ovid MEDLINE, and Cochrane Library database up to October 2019. RCTs of patients with CKD comparing HIF-PHIs with erythropoiesis-stimulating agents (ESAs) or placebo in the treatment of anemia. The primary outcome was hemoglobin change from baseline (Hb CFB); the secondary outcomes included iron-related parameters and the occurrence of each adverse event. 26 trials in 17 articles were included, with a total of 2804 dialysis or patients with CKD. HIF-PHIs treatment produced a significant beneficial effect on Hb CFB compared with the placebo group (MD, 0.69; 95% CI, 0.36 to 1.02). However, this favored effect of HIF-PHIs treatment was not observed in subgroup analysis among trials compared with ESAs (MD, 0.06; 95% CI, -0.20 to 0.31). https://www.selleckchem.com/products/sb297006.html The significant reduction in hepcidin by HIF-PHIs was observed in all subgroups when compared with the placebo group, whereas this effect was observed only in NDD-CKD patients when compared with ESAs. HIF-PHIs increased the risk of nausea (RR, 2.20; 95% CI, 1.06 to 4.53) and diarrhea (RR, 1.75; 95% CI, 1.06 to 2.92). We conclude that orally given HIF-PHIs are at least as efficacious as ESAs treatment to correct anemia short term in patients with CKD. In addition, HIF-PHIs improved iron metabolism and utilization in patients with CKD.The pandemic of respiratory disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is life-threatening in peritoneal dialysis (PD) patients. In PD patients with systemic viral infections, peritoneal effluent may be theoretically contaminated. We searched for the presence of SARS-CoV-2 genetic material by real-time reverse transcriptase-polymerase chain reaction assays in serial PD effluents of three PD infected patients. Nasopharyngeal swabs obtained at admission showed high viral load in all three patients, whereas none of the PD effluent specimen tested positive, even after dialysate concentration. Those results support at most a very low SARS-CoV-2 dissemination risk by the peritoneal effluent of PD patients. Imposing special disposal procedures, such as the instillation of hypochlorite in the drainage bags to prevent viral spread to health-care workers, are probably not required.Background It is beneficial for CI patients listen to music. However it is necessary to take steps to improve the musicality of CI patients.Objectives The aims of the study were to evaluate the primary musicality of children with cochlear implants versus those with normal hearing.Material and methods Children participating in this study were divided into two groups the cochlear implant group (CI group) and the normal hearing group (NH group). The 'Musical Ears Evaluation Form for Professionals' was used to evaluate the subjects' primary musicality.Results The scores for overall and the three subcategories of primary musicality in children with cochlear implants and in those with normal hearing also improved significantly over time (p  .05). There were significant differences between the two groups in the same chronological age (p  less then  .05).Conclusions and significance The primary musicality in children with cochlear implants was not significantly different from normal hearing ones at the same hearing age. The primary musicality in children with cochlear implants was significantly lower than that of children with normal hearing at the same chronological age.

We conducted a systematic review about antibiotic-loaded bone cement (ALBC) with a focus on clinical evidence about ALBC in general, concerns about ALBC and ALBC cost.BACKGROUND Patient-reported outcome measures (PROMs) after total hip arthroplasty (THA), can be influenced by patient characteristics (case-mix factors). We used the Dutch Arthroplasty Register (LROI) to determine the effect of case-mix on improvement of PROMs after primary THA. METHODS We included all primary THAs (n = 22,357) performed in the Netherlands between 2014 and 2018. The Hip disability and Osteoarthritis Outcome Score Physical function short form (HOOS-PS), Oxford Hip Score (OHS), EQ-5D index score and thermometer, and Numeric Rating Scales (NRS) measuring pain during activities and at rest, were recorded. The difference between preoperative and 3- and 12-month postoperative scores was calculated (delta-PROM) and used as primary outcome variable. Multivariable linear regression was used to examine the association between patient characteristics (age, sex, ASA score, body mass index (BMI), Charnley class, smoking, and previous operations to the affected hip) and PROMs. Cohens' d was used to measure effect size. RESULTS Postoperative improvement (delta-PROM) on HOOS-PS, OHS, EQ-5D, and pain relief were significantly higher in patients 30 kg/m2, and patients without a previous operation to the hip. Cohen's d indicated clinically small differences (0.2). CONCLUSIONS Patients benefiting most in terms of postoperative improvement of self-reported physical functioning, pain relief and quality of life after primary THA were young, female, with a high ASA or BMI score, and without previous operations to the hip.PURPOSE To compare the efficacy between fixed and variable treatment regimens of subthreshold yellow micropulse laser for the treatment of diabetic macular edema. METHODS This is a retrospective, comparative, 12-month study of 39 eyes 24 eyes received fixed treatment regimen of subthreshold micropulse laser treatment and 15 eyes underwent variable treatment regimen of subthreshold micropulse laser, all eyes were followed up for 12 months. Subthreshold micropulse laser was performed with the following parameters 100 μm spot size on slit lamp, 5% duty cycle of 0.2 s, and 250 mW power. To choose the power of the variable treatment regimen of subthreshold micropulse laser group, continuous laser power was titrated to a barely visible burn and then switched to MicroPulse mode, multiplying the test burn power by 4 and using a 5% duty cycle of 0.2 s. Main outcomes included changes in central macular thickness and best-corrected visual acuity. RESULTS At baseline, the mean LogMAR best-corrected visual acuity was 0.29ing the possible errors due to wrong titration in the switch from continuous to micropulse mode.A new aromatic glycoside (1) and a new natural product, neolignan (2), along with twenty-three known compounds (3-25), were isolated from the thorns of Gleditsia sinensis. According to the spectroscopic analyses (IR, UV, HRESIMS, NMR and ECD), the structures of isolates were elucidated. Herein, compounds 4, 6-8, 10-13, 15, 16, 18, 20, 23 were isolated from the plant of G. sinensis for the first time. Moreover, compounds 4, 6, 15 and 24 showed cytotoxic effects on human ovarian cancer (SKOV-3) cells with IC50 values of 24.83 ± 4.90, 48.86 ± 9.11, 80.13 ± 5.62, 15.38 ± 2.21 μM, respectively.[Formula see text].A 21-d experiment was conducted to investigate the effect of graded inclusions of waxy starch hull-less (WSHL) barley and a multi-component exogenous carbohydrase on the growth performance, nutrient digestibility and intestinal morphometry of broiler chickens. Five levels of WSHL barley inclusion (0, 65, 130, 195 and 260 g/kg) in a wheat-based diet, and two levels of enzyme supplementation (0 and 150 g/tonne of feed) were evaluated in a 5 × 2 factorial arrangement of 10 dietary treatments. All diets were equivalent in metabolisable energy and digestible amino acid content. A total of 400, one-d-old male broilers (five cages/treatment; eight birds/cage) were used in the experiment.Regardless of enzyme supplementation, feed intake declined (P less then 0.001) with increasing inclusion of WSHL barley. https://www.selleckchem.com/products/rg-7112.html Increasing levels of WSHL barley (P less then 0.001) and supplemental enzyme (P less then 0.01) increased gain to feed ratio.Birds fed diets with 0 g/kg WSHL barley showed the lowest (P less then 0.001 to 0.01) digestibility for all nutrients except starch. Only starch digestibility was improved (P less then 0.05) by enzyme supplementation. The nitrogen-corrected apparent metabolisable energy improved with increasing inclusion of WSHL barley (P less then 0.001) and supplemental enzyme (P less then 0.001). Increasing inclusion of WSHL barley increased the relative weight of gizzard (P less then 0.001) and reduced jejunal digesta viscosity (P less then 0.01). Supplemental enzyme (P less then 0.001) reduced digesta viscosity.All levels of WSHL barley inclusion improved digestibility of dry matter, nitrogen and fat, whilst energy utilisation improved at inclusions of 130 g/kg WSHL and above, probably due to lowered digesta viscosity and better development of the gizzard. Gain to feed ratio, starch digestibility, energy utilisation and jejunal digesta viscosity can benefit from carbohydrase supplementation in wheat-based diets, regardless of barley inclusion level.Birds' newly oviposited blastoderms can survive several weeks in a dormant state during low-temperature storage. Previous studies demonstrated that there is a critical temperature range from 19 to 27℃ for chicken embryos. Within this range, the embryo will diapause in a dormant state; once the temperature rises above this range, the blastoderm will break dormancy.Clarifying the mechanism that initiates duck embryo developmental recovery from blastoderm dormancy will be helpful to change temperature control to improve hatching in poultry production. It was hypothesised that there might be some temperature-sensitive genes involved in initiating duck embryo developmental recovery from blastoderm dormancy.To test this hypothesis, the transcriptome of the newly oviposited duck blastoderm and duck embryo (incubated for 48 hours) were sequenced to screen for differentially expressed genes with functions that had been predicted by bioinformatics.The results showed that there were 2416 differentially expressed genes between the two groups, 53 of which were involved in temperature-sensitive pathways.

Our understanding of the rises of animal and cancer multicellularity face the same conceptual hurdles what makes the clade originate and what makes it diversify. Between the events of origination and diversification lies complex tissue organization that gave rise to novel functionality for organisms and, unfortunately, for malignant transformation in cells. Tissue specialization with distinctly separated cell fates allowed novel functionality at organism level, such as for vertebrate animals, but also involved trade-offs at the cellular level that are potentially disruptive. These trade-offs are under-appreciated and here we discuss how the wide separation of cell phenotypes may contribute to cancer evolution by (a) how factors can reverse differentiated cells into a window of phenotypic plasticity, (b) the reversal to phenotypic plasticity coupled with asexual reproduction occurs in a way that the host cannot adapt, and (c) the power of the transformation factor correlates to the power needed to reverse tissue specialization. The role of reversed cell fate separation for cancer evolution is strengthened by how some tissues and organisms maintain high cell proliferation and plasticity without developing tumours at a corresponding rate. This demonstrates a potential proliferation paradox that requires further explanation. These insights from the cancer field, which observes tissue evolution in real time and closer than any other field, allow inferences to be made on evolutionary events in animal history. If a sweet spot of phenotypic and reproductive versatility is key to transformation, factors stimulating cell fate separation may have promoted also animal diversification on Earth.The rationale for the antibiotic treatment of viral community-acquired pneumonia (CAP) in adults was analyzed to develop a clinical reference standard for this condition. Clinical data from 166 patients diagnosed with viral pneumonia across 14 hospitals in Beijing from November 2010 to December 2017 were collected. The indications for medications were evaluated, and the rationale for the use of antibiotics was analyzed. A total of 163 (98.3%) patients with viral pneumonia were treated with antibiotics. A combination of C-reactive protein (CRP) and procalcitonin (PCT) was used as markers to analyze the possible indications for antibiotic use. With threshold levels set at 0.25 µg/L for PCT and 20 mg/L for CRP, the rate of unreasonable use of antibiotics was 55.2%. By contrast, at a CRP level threshold of 60 mg/L, the rate of antibiotic misuse was 77.3%. A total of 39 of the 163 (23.9%) patients did not meet the guidelines for drug selection for viral CAP in adults. The unreasonable use of antibacterial drugs for the treatment of viral CAP in adults is a serious concern. Clinicians must reduce the unnecessary use of antibiotics.Sustainable management of iron (Fe) deficiency through the microbial association is highly desirable to ensure crop yield. This study elucidates whether and how arbuscular mycorrhizal fungi (AMF) ameliorate Fe deficiency symptoms in sorghum. https://www.selleckchem.com/products/jtc-801.html AMF inoculation showed a significant improvement in plant biomass, chlorophyll score, Fv/Fm (quantum efficiency of photosystem II), and Pi_ABS (photosynthesis performance index), suggesting its potentiality to diminish Fe deficiency symptoms in sorghum. This AMF-driven prevention of Fe deficiency was further supported by the improvement of biochemical stress indicators, such as cell death, electrolyte leakage, hydrogen peroxide, and superoxide anion. In this study, AMF showed a significant increase in phytosiderophore (PS) release as well as Fe and S concentrations in sorghum under Fe deficiency. Quantitative real-time PCR analysis demonstrated the consistent upregulation of SbDMAS2 (deoxymugineic acid synthase 2), SbNAS2 (nicotianamine synthase 2), and SbYS1 (Fe-phytosiderophore transporter yellow stripe) in roots due to AMF with Fe deficiency. It suggests that the enhancement of Fe due to AMF is related to the mobilization of Fe(III)-PS in the rhizosphere supported by the long-distance transport of Fe by SbYS1 transporter in sorghum. Our study further showed that the elevation of S mainly in the presence of AMF possibly enhances the S-containing antioxidant metabolites (Met, Cys, and GSH) as well as enzymes (CAT, SOD, and GR) to counteract H2O2 and O2- for the restoration of redox status in Fe-deprived sorghum. Moreover, S possibly participates in Strategy II responses revealing its crucial role as a signaling molecule for Fe homeostasis in sorghum.Amazon fish are vulnerable to climate change. Current temperature increases in Amazonian rivers are likely to continue in the coming years. Elevated temperatures impair homeostasis and subject fish to oxidative stress; nevertheless, the effects of elevated temperature on plasma and muscle oxidative stress as well as fillet fatty acid composition in matrinxã (Brycon amazonicus) remain unknown. Therefore, the aims of the present study were to determine whether antioxidant system is able to withstand acute thermal stress to avoid plasma and muscle oxidative damage and to determine the manner in which matrinxã adjust their muscle fatty acid metabolism in a response to acute heat stress. We exposed juvenile matrinxã to four temperatures (28 °C as control and 30, 32, and 34 °C) for 72 h and observed the effects on plasma and muscle oxidant/antioxidant status and on fatty acid composition. Plasma reactive oxygen species (ROS) and lipid peroxidation (LPO) levels were significantly higher in matrinxã exposed to 34 °C increased levels of total SFA and decreased levels of PUFA occur in an attempt to withstand heat stress and maintain membrane fluidity; nevertheless, these responses can represent negative impacts for consumers.Egg-envelope, an acellular coat, surrounds the egg and is essential for vitellogenin incorporation. It also plays a pivotal role during fertilization and provides protection to the developing embryo. In the present study, scanning electron microscopy was used to elucidate the structural details of isolated egg-envelopes from the Indian freshwater murrel, Channa punctatus. Several pores and single micropyle were observed on outer surface, whereas inner layer indicated deposition of proteinaceous material. The constituent proteins of egg-envelope were further characterized by Fourier transform infrared (FT-IR) spectroscopy, and electrophoresis and mass-spectrometry (MALDI-TOF-MS/MS). The secondary structure of egg-envelope proteins showed the presence of antiparallel ß-pleated sheets and aromatic amino acids. These proteins resolved into two peptides (130 kDa and 68 kDa) under denaturing conditions, which exhibited glycoprotein nature. The peptide band with low molecular mass showed significant similarity with transmembrane protein, whereas peptide band with high molecular mass matched with choriogenin protein of other fishes.

In Quebec, the strategic leadership of nursing directorates remains poorly documented despite its importance for the performance of their organizations. https://www.selleckchem.com/products/azd5153-6-hydroxy-2-naphthoic-acid.html Using three focus groups and 31 individual semistructured interviews, a qualitative descriptive study was conducted, including 35 participants from 18 of the Quebec 34 health institutions created in 2015 by the last reform. Seven themes emerged (1) taking ownership of the strategic positioning, (2) developing and communicating a vision, (3) making strategic, systematic, and measured choices, (4) reframing roles, (5) getting involved in the strategic decision-making processes, (6) developing the political capacity, and (7) building alliances. Four professional and organizational components influenced the nursing directorates' leadership capacity clinical credibility, a sufficient number of people educated at the graduate level, organizational culture, and size of the institution. It is expected that these results regarding nursing directorates' exercise of strategic leadership will lead to better governance and quality of nursing care.The recent COVID-19 pandemic has highlighted limitations in current healthcare systems and needed strategies to increase surgical access. This article presents a team-based integration model that embraces intra-disciplinary collaboration in shared clinical care, professional development, and administrative processes to address this surge in demand for surgical care. Implementing this model will require communicating the rationale for and benefits of shared care, while shifting patient trust to a team of providers. For the individual surgeon, advantages of clinical integration through shared care include decreased burnout and professional isolation, and more efficient transitions into and out of practice. Advantages to the system include greater surgeon availability, streamlined disease site wait lists, and promotion of system efficiency through a centralized distribution of clinical resources. We present a framework to stimulate national dialogue around shared care that will ultimately help overcome system bottlenecks for surgical patients and provide support for health professionals.Many healthcare organizations have adopted the quadruple aim to create system-level improvements for delivering enhanced experience and outcomes to patients, healthier populations, reduced per-capita costs, and better provider experiences. With a maturing health technology sector, virtual care is gradually being adopted in Canada and proving to be a viable tactic for achieving the quadruple aim. Despite increased acceptance of virtual innovations and their related benefits to patients and providers, implementation of virtual care can be challenging in a Canadian healthcare system. The Ottawa Hospital developed an innovation strategy to guide the adoption and maturity of virtual care as a means of supporting the pursuit of the quadruple aim and achievement of the organization's mission and vision. A case example presenting the strategy and recommendations for health leaders and providers considering implementation of virtual care is discussed. This study aimed to explore health professional, patient, family, and caregiver perceptions of palliative care, availability of palliative care services to patients across South Dakota, and consistency and quality of palliative care delivery. Six focus groups were conducted over two months. Participants included interprofessional healthcare team members, patients, family members of patients, and caregivers. Individuals with palliative care experiences or interest in palliative care were invited to participate. Recruitment strategies included emails, flyers, and direct contact by members of the Network. Snowball sampling was used to recruit participants. Forty-six participants included patients, family members, caregivers and interprofessional health care team members. Most participants were Caucasian (93.3%) and female (80%). Six primary themes emerged Need for guidance toward the development of a holistic statewide palliative care model; Poor conceptual understanding and awareness; Insufficient resourct of a holistic statewide palliative care model; Poor conceptual understanding and awareness; Insufficient resources to implement complete care in all South Dakota communities; Disparities in the availability and provision of care services in rural SD communities; Need for relationship and connection with palliative care team; and Secondary effects of palliative care on patients/family/caregivers and interprofessional healthcare team members. Significance of Results Disproportionate access is a principle problem identified for palliative care in rural South Dakota. Palliative care is poorly understood by providers and recipients of care. Service reach is also tempered by lack of resources and payer reimbursement constraints. A model for palliative care in these rural communities requires concerted attention to their unique needs and design of services suited for the rural residents.Aim This study aims to investigate the significance of a micropapillary pattern in stage IIIA-N2 lung adenocarcinoma after adjuvant chemoradiotherapy. Patients & methods A total of 257 patients with stage IIIA-N2 lung adenocarcinoma were enrolled in this study. Patients were classified into three groups based on the proportion of micropapillary components micropapillary negative, micropapillary minor component and micropapillary predominant component. Results The micropapillary predominant group had the shortest median disease-free survival and overall survival times compared with the micropapillary minor component and micropapillary negative groups (median overall survival time 54 months vs 64 months vs not reached; p = 0.004). Furthermore, the micropapillary pattern was an independent prognostic factor for disease-free survival and overall survival (p less then 0.05). Conclusion The micropapillary pattern of IIIA-N2 lung adenocarcinoma is related to worse prognosis.Aim To analyze responses to first-line metastatic renal cell carcinoma (mRCC) treatment stratified by risk criteria. Patients & methods Clinical trials and observational studies of patients aged ≥18 years, published January 2005-May 2019, were identified via Ovid from MEDLINE, EMBASE, the Cochrane Central Trials Register and the Cochrane Database of Systematic Reviews. Data extracted included progression-free survival (PFS), overall survival (OS) and objective response rate (ORR). Results 47/1269 articles met eligibility criteria. Most studies stratified patients by International Metastatic RCC Database Consortium (n = 19) or Memorial Sloan Kettering Cancer Center (n = 21). PFS, OS and ORR varied according to risk group. Conclusion Pembrolizumab + axitinib, ipilimumab + nivolumab and avelumab + axitinib were most effective across all risk groups. Favorable-risk patients benefit from sunitinib treatment.

The developmental trajectories of soccer players' EFs follow the general populations' despite long-term exposure to soccer-specific training and game play. This brings into question the relationship between high-level experience and EFs and renders including EFs in talent identification questionable.Social interactions are theorized to inform relation-inferred self-efficacy (RISE), which, in turn, may influence self-efficacy and behavior. This study investigated the effects of peer encouragement on RISE, task self-efficacy, and physical performance. Children (N = 84) were assigned to dyads and randomized to provide peer encouragement to one another or not (control group). Participants completed two endurance handgrip trials, separated by a cognitively demanding task intended to induce mental fatigue and increase the salience of the peer encouragement manipulation. Participants in the experimental group exchanged words of encouragement prior to the second endurance trial, whereas those in the control group did not. The peer encouragement group reported higher RISE and showed increased performance across trials compared with controls. Providing peer encouragement prior to a challenging physical task was associated with more positive RISE perceptions and improved physical performance.The purpose of this study was to examine if physical activity is related to greater executive functions among youth in poverty. Executive functions (cognitive flexibility, inhibition, and working memory) and physical activity were measured in participants (N = 149) in the fifth to eighth grade from three schools located in high-poverty districts. Pearson correlations revealed a statistically significant correlation between physical activity and cognitive flexibility (r = .18, p less then .05). Hierarchical multiple regressions revealed that physical activity significantly improved prediction for cognitive flexibility, R2 = .09, F(6, 142) = 2.26, p = .041, adjusted R2 = .05, above sex, maturity, and school district. A two-way multivariate analysis of covariance revealed statistically significant differences in working memory in more active youth compared with less active but no statistically significant differences in cognitive flexibility or inhibition (p less then .05). Greater physical activity is associated with greater working memory among youth in poverty.This study presents a description and understanding of the physical activity of low-income older adults in Singapore, with specific focus on their communication and interactions with social partners. Ethnographic observations and participant interviews (N = 10) were conducted with a purposive sample. Findings contained descriptions of actual behaviors of the target group and explanations of the influences on their physical activity, ranging from the intrapersonal sphere, to communication with their strong-tie networks, and finally, interactions with the community and environment surrounding them. The author takes a social ecological viewpoint on the topic, uncovering the lived experiences of the target audience, and suggests how theory, research, and practical policies may be improved to better support those at the lower end of the socioeconomic strata.The aim of the study was to compare the effects of three water-based training on blood pressure (BP) in older women. A total of 57 participants were randomized into the following groups (a) aerobic training (AT), (b) concurrent training in which resistance training progresses to the use of resistive equipment (CTRE), and (c) concurrent training in which resistance training progresses to multiple sets (CTMS). The participants trained twice a week for 16 weeks. Systolic BP decreased from pretraining to after 8 weeks of training and, subsequently, to after 16 weeks of training (AT -6.53 mmHg, CTRE -10.45 mmHg, and CTMS -10.73 mmHg). Diastolic BP decreased from pretraining to after 8 and 16 weeks of training (AT -6.23 mmHg, CTRE -4.61 mmHg, and CTMS -6.19 mmHg). Furthermore, 16% of the AT participants, 23% of the CTRE participants, and 28.5% of the CTMS participants were no longer classified as hypertensive. https://www.selleckchem.com/products/cbr-470-1.html Water-based aerobic and concurrent training are efficient nonpharmacological measures to reduce BP in older women.Recent outbreaks of limb paralysis similar to poliomyelitis, termed acute flaccid myelitis (AFM), have prompted intense investigation into potential etiology. Peaks of AFM were seen in the United States in 2012, 2014, 2016 and 2018, coincident with peaks in enterovirus transmission, particularly EV-D68. Similar peaks of AFM and EV-D68 circulation were reported in other parts of the world. The causal relationship between EV-D68 is still not widely accepted as it is for poliovirus and EV-A71, the latter of which is endemic in the US. Recent in vitro and mouse model data as well as enhanced-sensitivity diagnostic assays have provided further evidence linking the causal relationship between EV-D68 and AFM. In addition, an outbreak of EV-A71-associated AFM was recently described, highlighting the possibility of an additional emerging non-polio enterovirus of public health concern. As AFM is a devastating disease with poor prognosis in many children, particularly those with EV-D68, recent studies call for increased surveillance, pursuit of novel therapeutics and strategies to prevent transmission before the next outbreak.Schizophrenia and autism spectrum disorder (ASD) are nosologically distinct neurodevelopmental disorders with similar deficits in social cognition, including the ability to form mental representations of others (i.e., mentalizing). However, the extent of patient deficit overlap in underlying neural mechanisms is unclear. Our goal was to examine deficits in mentalizing task-related (MTR) activity modulation in schizophrenia and ASD and the relationship of such deficits with social functioning and psychotic symptoms in patients. Adults, ages 18-34, diagnosed with either ASD or schizophrenia, and typically developed controls (n = 30/group), performed an interactive functional MRI Domino task. Using independent component analysis, we analyzed game intervals known to stimulate mentalizing in the default mode network (DMN), i.e., medial prefrontal cortex (MPFC), posterior cingulate cortex (PCC), precuneus, and temporoparietal junction (TPJ), for group differences in MTR activity and associations between MTR activity and social and psychosis measures.

Thus, the heart rate and the physical activity both are the inevitable parameters for the design of RDPM. Performance analysis of the proposed RDPM shows a significant reduction in the delay between sensing and pacing. Device utility analysis shows that the proposed design not only requires lesser memory but also reduces the number of components on the chip. Therefore, it becomes very clear that the proposed pacemaker design will consume much lesser power.High-altitude exposure typically reduces endothelial function, and this is modulated by hemoconcentration resulting from plasma volume contraction. However, the specific impact of hypobaric hypoxia independent of external factors (e.g., cold, varying altitudes, exercise, diet, and dehydration) on endothelial function is unknown. We examined the temporal changes in blood viscosity, shear stress, and endothelial function and the impact of plasma volume expansion (PVX) during exposure to hypobaric hypoxia while controlling for external factors. Eleven healthy men (25 ± 4 yr, mean ± SD) completed two 4-day chamber visits [normoxia (NX) and hypobaric hypoxia (HH; equivalent altitude, 3,500 m)] in a crossover design. Endothelial function was assessed via flow-mediated dilation in response to transient (reactive hyperemia; RH-FMD) and sustained (progressive handgrip exercise; SS-FMD) increases in shear stress before entering and after 1, 6, 12, 48, and 96 h in the chamber. During HH, endothelial function was also mes accompanied by elevated resting and exercising arterial shear stress. Flow-mediated dilation stimulated by reactive hyperemia and handgrip exercise was preserved throughout the hypoxic exposure. Plasma volume expansion reversed the hypoxia-associated hemoconcentration and selectively increased handgrip exercise flow-mediated dilation.In patients with heart failure, atrial septal defect (ASD) closure has a risk of inducing life-threatening acute pulmonary edema. The objective of this study was to develop a novel framework for quantitative prediction of hemodynamics after ASD closure. The generalized circulatory equilibrium comprises right and left cardiac output (CO) curves and pulmonary and systemic venous return surfaces. We incorporated ASD into the framework of circulatory equilibrium by representing ASD shunt flow (QASD) by the difference between pulmonary flow (QP) and systemic flow (QS). To examine the accuracy of prediction, we created ASD in six dogs. Four weeks after ASD creation, we measured left atrial pressure (PLA), right atrial pressure (PRA), QP, and Qs before and after ASD balloon occlusion. We then predicted postocclusion hemodynamics from measured preocclusion hemodynamics. Finally, we numerically simulated hemodynamics under various ASD diameters while changing left and right ventricular function. Predicted postocclusio be useful for safety management of ASD closure.Heart rate variability (HRV) is a measure of variation in time interval between heartbeats and reflects the influence of autonomic nervous system and circulating/locally released factors on sinoatrial node discharge. Here, we tested whether electrocardiograms (ECGs) obtained in conscious, restrained mice, a condition that affects sympathovagal balance, reveal alterations of heart rhythm dynamics with aging. Moreover, based on emergence of sodium channels as modulators of pacemaker activity, we addressed consequences of altered sodium channels on heart rhythm. C57Bl/6 mice and mice with enhanced late sodium current due to Nav1.5 mutation at Ser571 (S571E) at ~4 to ~24 mo of age, were studied. HRV was assessed using time- and frequency-domain and nonlinear parameters. For C57Bl/6 and S571E mice, standard deviation of RR intervals (SDRR), total power of RR interval variation, and nonlinear standard deviation 2 (SD2) were maximal at ~4 mo and decreased at ~18 and ~24 mo, together with attenuation of indexes of syrt rate and its age-related adaptations.The 60-kDa heat shock protein (HSP60) is a chaperone essential for mitochondrial proteostasis ensuring thus sufficient aerobic energy production. https://www.selleckchem.com/products/mlt-748.html In pathological conditions, HSP60 can be translocated from the mitochondria and excreted from the cell. In turn, the extracellular HSP60 has a strong ability to trigger and enhance inflammatory response with marked proinflammatory cytokine induction, which is mainly mediated by Toll-like receptor binding. Previous studies have found increased circulating levels of HSP60 in hypertensive patients, as well as enhanced HSP60 expression and membrane translocation in the hypertrophic myocardium. These observations are of particular interest, since they could provide a possible pathophysiological explanation of the severe course and worse outcome of severe acute respiratory syndrome coronavirus 2 infection in hypertensive patients, repeatedly reported during the recent coronavirus disease 2019 (COVID-19) pandemic and related to hyperinflammatory response and cytokine storm development during the third phase of the disease. In this regard, pharmacological inhibition of HSP60 could attract attention to potentially ameliorate inappropriate inflammatory reaction in severe COVID-19 patients. Among HSP60 antagonizing drugs, mizoribine is the most intriguing, since it is clinically approved and exerts antiviral activity. However, this topic requires to be further scrutinized.Heat acclimation (HA) may improve the regulation of cardiac output (Q̇) through increased blood volume (BV) and left ventricular (LV) diastolic filling and attenuate reductions in Q̇ during exercise-induced dehydration; however, these hypotheses have never been directly tested. Before and following 10-days exercise HA, eight males completed two trials of submaximal exercise in 33°C and 50% relative humidity while maintaining preexercise euhydrated body mass (EUH; -0.6 ± 0.4%) or becoming progressively dehydrated (DEH; -3.6 ± 0.7%). Rectal (Tre) and skin (Tsk) temperatures, heart rate (HR), LV volumes and function, systemic hemodynamics and BV were measured at rest and during bouts of semirecumbent cycling (55% V̇o2max) at 20, 100 and 180 min, interspersed by periods of upright exercise. Tre, BV, HR, LV volumes, LV systolic and diastolic function, and systemic hemodynamics were similar between trials at rest and during the first 20 min of exercise (all P > 0.05). These responses were largely unaffected by HA at 180 min in either hydration state.

Background Despite the recognition of food allergies as a significant cause of morbidity and a growing public health burden worldwide, there are no epidemiological studies addressing food sensitization and allergy in Jordan. Objective To conduct an epidemiological study that retrospectively analyzes sensitization data from 3463 patients with suspected immunoglobulin E (IgE)-mediated food allergic reactions who performed specific IgE tests in our laboratories in Jordan. Methods Specific IgE (s-IgE) tests were analyzed for patients who performed enzyme allegro-sorbent testing based on either self-reported food allergy or upon physician's request. Results 2.3% of the analyzed samples were cross-reactive to carbohydrate determinants. A quarter of the patients were sensitized to one or more food allergens, with males having higher odds of being s-IgE positive. Furthermore, a higher prevalence of sensitization was seen in infants and children compared with adults. s-IgE was most frequently found against cow milk (11.2%), pistachio (4.9%), soybean (4.6%), cherry (4.4%), and orange (4.4%). Interestingly, the s-IgE class distribution profile of pistachio differed from the rest of the top hits being skewed away from the weak class 1 leaning more towards higher IgE classes. Food allergen sensitization was age group-dependent milk, tree nuts, and eggs were the main food groups causing sensitization in infants, while it was fruits followed by milk in children and adults. Conclusions Our work represents the first epidemiological study addressing food sensitization in Jordan. This study lays a solid foundation for future studies that can help better guide food allergy diagnosis, patient dietary modifications, and food elimination plans, as well as assist decision-makers in the region to develop national strategies for an efficient and sustainable healthcare system.Objective The endothelial glycocalyx covers the luminal surface of the endothelium and plays key roles in vascular function. Despite its biological importance the ideal visualisation techniques are lacking. The current study aimed to improve the preservation and subsequent imaging quality of the endothelial glycocalyx. Methods In mice, the endothelial glycocalyx was contrasted with a mixture of Lanthanum and Dysprossium (LaDy). Standard chemical fixation was compared with high pressure frozen specimens processed with freeze substitution. Also, isolated brain microvessels and cultured endothelial cells were high pressure frozen and by transmission soft x-ray imaged under cryogenic conditions. Results The endothelial glycocalyx was in some tissues significantly more voluminous from chemically fixed specimens compared with high-pressure frozen specimens. LaDy labelling introduced excessive absorption contrast which impeded glycocalyx measurements in isolated brain microvessels when using transmission soft x-rays. In non-contrasted vessels, the glycocalyx was not resolved. LaDy-contrasted, cultured brain endothelial cells allowed to assess glycocalyx volume in vitro. Conclusions Both chemical and cryogenic fixation followed by dehydration lead to substantial collapse of the glycocalyx. Cryogenic fixation without freeze substitution could be a way forward although transmission soft x-ray tomography based solely on amplitude contrast seems unsuitable.Vision therapy in the form of ocular motor training is increasingly used to treat visual complaints, particularly in the setting of persistent symptoms after mild traumatic brain injury (mTBI). In this review, we discuss the rationale behind this intervention and the evidence for its utility. Although the efficacy of exercises for primary convergence insufficiency is plausible and supported by data, there is not yet strong evidence of benefit for the post-traumatic variant. It is not established that abnormalities in fixation, pursuit, and saccades in mTBI are the cause of post-concussive symptoms, or that these abnormalities arise from ocular motor damage rather than being secondary effects of cognitive problems with attention or executive control. https://www.selleckchem.com/products/ki16198.html The few studies to date have significant methodological weaknesses. More substantial evidence is required before vision therapy can be accepted as a useful tool in the rehabilitation of patients with brain trauma. ANN NEUROL 2020.Background and objective Previous studies have suggested that early pulmonary rehabilitation (PR) programmes post-AECOPD are an effective and safe intervention for reducing hospital admissions and improving quality of life. This study assessed whether a short course of exercise training post-AECOPD with periodic reinforcement exercise training and phone call reminders reduces readmissions and increases physical activity in COPD patients. Methods Subjects were randomized into either the (i) intervention group (IG), consisting of 4-8 weeks of training supervised by a physiotherapist and phone contact every 2 weeks by a case manager providing support and reinforcement of continuous exercise at home or (ii) usual care group (UG), which had no input by a physiotherapist or case manager. Readmissions were assessed at 12 months. Activities of all patients were assessed by an activity monitor at baseline, 3 and 12 months. Results Altogether, 136 subjects were included and randomized (68 in IG and 68 in UG). The age, gender and FEV1 % predicted were 75.0 ± 6.7 years, 132 males and 47.0 ± 16.2%, respectively. The mean number of readmissions for AECOPD (1.06 vs 1.72 times, P = 0.014) was less and time to first readmission was increased (146.8 vs 122.4 days, P = 0.005) in the IG versus UG at 12 months. At 12 months, there was no change in activity measured by activity monitor between the two groups. Conclusion This programme decreased exacerbation frequency and increased the time of readmissions for AECOPD. It did not improve physical activities and exercise tolerance at 12 months.Microtextures of titanite (CaTiSiO5 ) in exceptionally preserved Archean pillow lavas have been proposed as the earliest examples of microbial ichnofossils. An origin from microbial tunneling of seafloor volcanic glass that is subsequently chloritized and the tunnels infilled by titanite has been argued to record the activities of subseafloor microbes. We investigate the evidence in pillow lavas of the 3.35 Ga Euro Basalt from the Pilbara Craton, Western Australia, to evaluate the biogenicity of the microtextures. We employ a combination of light microscopy and chlorite mineral chemical analysis by EPMA (electron probe micro-analysis) to document the environment of formation and analyze their ultrastructure using FIB-TEM (focussed ion beam combined with transmission electron microscopy) to investigate their mode of growth. Petrographic study of the original and re-collected material identified an expanded range of titanite morphotypes along with early anatase growth forming chains and aggregates of coalesced crystallites in a sub-greenschist facies assemblage.

Supramolecular mechanofluorophores based on charge-transfer (CT) interactions between fluorescent pyrene and naphthalene diimide(s) with a tandem structure are newly developed and incorporated into the mid-chain of poly(ε-caprolactone)s. The fluorescence (FL) is quenched by the intramolecular CT interactions even at low concentrations both in solution and in the polymer matrix, and turn-on FL is induced upon application of mechanical forces.One of the challenges when using lithium metal as the anode in rechargeable lithium batteries is the formation and growth of lithium dendrites. The recent observation by He et al. (Nat. Nanotechnol., 2019, 14, 1042-1047) and Zhang et al. (Nat. Nanotechnol., 2020, 15, 94-98) confirm the presence of the root-growth mode for the growth of lithium dendrites (whiskers, spheres and hillocks). In this work, we introduced a non-Newtonian flow model to describe the flow of lithium in lithium metal and incorporate the contributions of viscous dissipation, surface energy, kinetic energy and strain energy in the analysis of the stress relaxation and the growth of a Li-sphere and a Li-whisker. Nonlinear second-order differential equations are derived for the growth of the Li-sphere and the Li-whisker. Closed-form solutions for the temporal evolution of the Li-sphere and the Li-whisker are obtained under the conditions such that the contributions of the surface energy, kinetic energy and strain energy stored in the cantilever beam to the stress relaxation in the lithium metal are negligible. Using the Lippmann relation in specific surface energy, we demonstrated that increasing the electric potential reduces the resistance to the flow of lithium into the Li-sphere and the Li-whisker. The results reveal the need to suppress the cycling-induced strain energy (misfit strain and biaxial modulus) in order to mitigate the growth of Li dendrites (whiskers, spheres and hillocks).Catechinic acid (CA), widely present in tea and fruits, has vital biological and pharmacological properties. CA plays an important role in the regulation of lifespan. However, the mechanism behind its anti-aging properties remains poorly characterized. In the present study, Caenorhabditis elegans (C. elegans) was used as a model organism. It was found that CA induced mitophagy which prevented the accumulation of dysfunctional mitochondria with age and profoundly extended lifespan. Notably, CA significantly improved the fitness of aging worms, particularly the treatment slowed age-related decline in observed spontaneous movements. Furthermore, CA was found to eliminate dysfunctional mitochondria in the gut and muscle cells, and demonstrated that the lifespan-prolonging effects of CA can be attributed to mitophagy along with the likely regulation of the genes bec-1 and pink-1. The results of this study indicated that pharmacologically induced mitophagy has a profound impact on aging, providing a novel therapeutic intervention against aging and age-related diseases.Transition-metal-catalyzed carbene transfer reactions, involving diazo compounds and their precursors, are powerful tools for creating new C-C bonds. Depending on the involved catalytic system, the carbene insertion can efficiently be driven towards a specific functional group for the synthesis of a wide portfolio of fine chemicals. The present report is focused on the catalytic activity of iron catalysts in promoting alkene cyclopropanations, C-H and X-H (X = N, O, S, Se, Si, Sn, Ge) functionalizations. Porphyrin, porphyrinoid and non-heme iron complexes are discussed by analyzing experimental studies and theoretical calculations performed for proposing reaction mechanisms. The catalytic activity of artificial iron biocatalysts is also briefly reported in order to underline the similarities and differences between reaction mechanisms mediated by modified biocatalysts and synthetic catalysts. This review summarizes the achievements made in this field since 2006.The abnormal concentrations of both biothiols and pH in lysosomes are seriously related to many major diseases, such as Parkinson's and Alzheimer's diseases. Up to now, there are few reports that clearly illustrate the relationship between lysosomal pH and biothiols via fluorescence assay. Herein, novel carbon dots (Scy-CDs) are prepared with good water dispersibility and excellent photostability, and a large Stokes shift of 106 nm is exhibited under an excitation wavelength of 450 nm. The remarkable pH-dependent behavior of Scy-CDs is presented with the fluorescence quenching based on the donor-excited photoinduced electron transfer (d-PET) process. The pKa value is 5.30, which is in good agreement with the range of the normal and abnormal lysosomal pH. Upon the addition of cysteine (Cys) or homocysteine (Hcy), the d-PET process is effectively inhibited with fluorescence recovery totally. The significant co-localization of Scy-CDs with Lyso-Tracker Deep Red in HEp-2 cells and the Pearson correlation coefficient 0.88 strongly suggest that the Scy-CDs can target lysosomal pH and Cys/Hcy in living cells.We study the two-dimensional assemblies of interacting colloidal particles in a loosely focussed optical trap. As the optical confinement is increased, the system becomes ordered and we investigate how these crystallites maintain their order under externally imposed oscillation. For small amplitudes, the crystalline order remains intact and the system behaves like a rigid body as predicted by numerical simulations. However, the rigidity breaks at large amplitudes, which we infer to be caused by the anharmonic component of the confinement potential. These studies are general enough to be applied to other physical systems comprising ordered finite-sized assemblies under external dynamic perturbation.This study presents the first local measurements of metals in snow from the Argentine Central Andes. https://www.selleckchem.com/products/resatorvid.html Cu, Pb and Zn were selected as specific tracers of anthropogenic local emission sources in the study area. Snow samples were collected during winter (2014, 2015 and 2016) at two sites with different characteristics Punta de Vacas and Vallecitos. The samples were analyzed by ICP-MS, and the average concentrations found were 1.4 μg L-1 (Cu), 2.2 μg L-1 (Pb) and 14.2 μg L-1 (Zn) in the snow samples from Vallecitos, and 5.3 μg L-1 (Cu), 2.6 μg L-1 (Pb) and 24.0 μg L-1 (Zn) in the snow samples from Punta de Vacas. These data and the snowfall amount in each sampling site were statistically analyzed. Results suggested that the levels of metals in the snow are influenced not only by the atmospheric concentrations, but also by the amount of precipitated snow. Additionally, an atmospheric dispersion model, CALPUFF, was applied in the study area to determine the origin of the studied metals and to understand the spatial distribution pattern of the concentrations found.