scholarly journals Evaluation of Factors Affecting Outcome in Growth Hormone–Secreting Pituitary Adenomas

2017 ◽  
Vol 06 (03) ◽  
pp. 176-183
Author(s):  
Amit Padwal ◽  
Jagath Gangadharan ◽  
Dwarakanath Srinivas ◽  
Sampath Somanna
Keyword(s):  
Growth Hormone ◽  
Pituitary Adenomas ◽  
Menstrual Irregularity ◽  
Factors Affecting ◽  
Factors Influencing ◽  
Case Files ◽  
Main Factors ◽  
Invasive Adenoma ◽  
Visual Complaints

Introduction Management of functioning pituitary adenomas is challenging as they can present with features of an intracranial mass, systemic effects, or a combination of both. In this series, one of the largest in available literature from our country, we have analyzed our experience with surgical management of growth hormone (GH)-secreting pituitary adenomas and factors influencing their hormonal remission. Materials and Methods The data of all functional pituitary adenomas operated at our institute from January 2002 to December 2011 were obtained from the case files of these patients. This was studied for various clinical-radiologic features, management stratagems, and clinical and hormonal outcomes. Results Ninety-three patients of GH-secreting pituitary adenomas with a mean age of 32.7 years were included in the study. Fifty-three (57%) patients had headache at presentation; 46 (49%) had visual complaints, whereas menstrual irregularity was seen in majority of females. Mean GH level was 52.05 ng/mL. Fifty (53%) patients had invasive adenoma; 32 had cavernous sinus extension. Among 80 patients with hormonal follow-up, 43 (53.75%) achieved remission of GH level < 5 ng/mL. Conclusion In this series, one of the largest of its kind, the main factors influencing unfavorable outcome include macroadenomas, invasiveness, high basal GH > 45 ng/mL levels, and mixed adenomas.

scholarly journals Retear rates after rotator cuff surgery: a systematic review and meta-analysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Umile Giuseppe Longo ◽  
Arianna Carnevale ◽  
Ilaria Piergentili ◽  
Alessandra Berton ◽  
Vincenzo Candela ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Meta Analysis ◽  
Fatty Infiltration ◽  
Surgical Techniques ◽  
Postoperative Rehabilitation ◽  
Rehabilitation Protocol ◽  
Factors Influencing ◽  
Main Factors ◽  
Tear Size

Abstract Background Rotator cuff retear (RCR) is one of the main postoperative drawbacks. RCR can be considered a multifactorial issue, which causes are related either to biological than biomechanical factors. The aim of this study was to define the incidence of RCR after surgical treatment at different time points and to identify the main factors influencing the postoperative rotator cuff (RC) healing. Methods A systematic review and meta-analysis were performed following the PRISMA guidelines. A comprehensive search of the literature was carried out in July 2020, using PubMed and Cochrane Library databases. Only level 1 and 2 clinical evidence studies were included. Studies were included if patients with preoperative repairable full-thickness RC tears were treated surgically, and if studies reported postoperative RCR confirmed by imaging diagnostic. The association between timing of retear and follow-up time points were investigated using an inverse-variance method of pooling data. A subgroup meta-analysis was performed using the DerSimonian and Laird method for the estimation of the between-study variance, i.e., τ2. The association between retear rate after surgery and patients’ age, preoperative tear size, fatty infiltration, postoperative rehabilitation protocol, surgical techniques, and RC repairs was determined by expressing the effect measure in terms of odds ratio (OR) with 95% confidence interval (CI). The Mantel-Haenszel method with 95% CIs was used. Results Thirty-one articles were included in this study. The percentage of RCR after surgery was 15% at 3 months follow-up, 21% at 3–6 months follow-up, 16% at 6–12 months follow-up, 21% at 12–24 months follow-up, 16% at follow-up longer than 24 months. The main factors influencing RC healing are both patient-related (i.e., age, larger tear size, fatty infiltration) and not patient-related (i.e., postoperative rehabilitation protocol, surgical techniques, and procedures). Conclusions Postoperative RC healing is influenced by patient-related and non-patient-related factors. Further high-level clinical studies are needed to provide highly relevant clinical results.

scholarly journals An empirical investigation of physical literacy-based adolescent health promotion

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Minmin Du ◽  
Yimin Liu ◽  
Lei Li
Keyword(s):  
Health Promotion ◽  
Adolescent Health ◽  
Panel Survey ◽  
Physical Literacy ◽  
Factors Affecting ◽  
Training Models ◽  
Study Results ◽  
Main Factors ◽  
Physical Elements

Abstract A reexamination of the health problems of Chinese adolescents based on the concept of physical literacy (PL) was necessary. Through the use of follow-up data collected from the China Education Panel Survey 2014–2015, the main factors affecting the health of adolescents were identified, and possible explanations were investigated after cluster and inductive analyses were conducted. The results showed that (1) the 10 main factors identified as affecting adolescent health promotion are in line with the four main elements of PL (emotional, cognitive, social and physical elements) and (2) the three major categories of influencing factors identified through a cluster analysis were aligned with the three main factors of PL (endogeneity, fundamentality and permeability). These findings suggest that the factors influencing adolescent health promotion are closely associated with PL. The study results can provide empirical evidence for adolescent health promotion research and a reference for the development of evidence-based PL training models.

scholarly journals Alternate Strip Clearcutting in Upland Black Spruce: II. Factors Affecting Regeneration in First-cut Strips

1987 ◽  
Vol 63 (6) ◽  
pp. 439-445 ◽  
Author(s):  
John K. Jeglum
Keyword(s):  
Natural Regeneration ◽  
Black Spruce ◽  
Mineral Soil ◽  
Strip Width ◽  
Seedling Density ◽  
Factors Affecting ◽  
Topographic Position ◽  
Factors Influencing ◽  
Main Factors ◽  
Upper Slope

In a two-cut, alternate strip clearcutting system in upland black spruce, the main factors influencing black spruce regeneration in the first-cut strips were strip width, natural seeding period, amount of receptive seedbed and topographic position. In the three study areas, 80-m strips yielded over 60% stocking and over 7 500 seedlings per hectare with a 4-year natural seeding period. Narrower strips 40 m and 20 m wide showed increasing levels of reproduction. Four years of natural seeding gave better natural regeneration than two years. Seedling density and frequency in quadrats were correlated with the amount of receptive seedbed. Regeneration was more abundant on drainageways and lower slopes, and less abundant on upper slope and crest sites. For successful regeneration under similar climatic and physiographic conditions, strip widths should be no more than 80 m, and leave times no less than 3 years. It is essential to scarify the upland mineral soil sites, but scarification of lowland sites is not recommended, especially where there is abundant Sphagnum.

Analysis on Factors Influencing and Numerical Simulation of Hot Stamping Mold Cooling System

2014 ◽  
Vol 644-650 ◽  
pp. 16-20
Author(s):  
Hong Mei Yang
Keyword(s):  
Heat Transfer ◽  
Numerical Simulation ◽  
Cooling System ◽  
Hot Stamping ◽  
Cooling Water ◽  
Factors Affecting ◽  
Stamping Die ◽  
Factors Influencing ◽  
Main Factors ◽  
And Performance

Cooling system is an important component of hot stamping dies, directly affects the quality and performance of the product. This article studies the work of hot stamping die process variation in temperature and heat transfer methods, analyzes the main factors affecting the cooling effect, and the use of numerical simulation of the flow of cooling water to simulate the state, and proposed rationalization proposals.

scholarly journals ECONOMIC DEVELOPMENT UNDER REFORM AND WORLD INTEGRATION AND THE MAIN FACTORS INFLUENCING THE ECONOMIC GROWTH IN VIETNAM

2011 ◽  
Vol 14 (1) ◽  
pp. 5-27
Author(s):  
Canh Thi Nguyen ◽  
Son Hung Tran
Keyword(s):  
Economic Growth ◽  
Economic Development ◽  
Quantitative Model ◽  
Poverty Rate ◽  
Living Standards ◽  
Capital Investments ◽  
Factors Affecting ◽  
Factors Influencing ◽  
Reform Period ◽  
Main Factors

The purpose of this paper was to give an overview of economic development under reform and world integration and to evaluate the main factors influencing the growth of the Vietnamese economy during the reform period (1990-2009). Based on statistical data on the Vietnamese economy in the period of 1990-2009, this study analyzed the factors affecting economic growth. The policy changes, economic development, poverty rates and living standards of Vietnamese population are analyzed over the reform period using qualitative methods. The results of this study show that economic growth under reform and world integration has reduced the poverty rate and increased living standards of population in Vietnam. An evaluation of the factors influencing economic growth is made using a quantitative model of total factor productivity (TFP) and another econometric model. The findings from this quantitative analysis show that the growth of the Vietnamese economy was determined by two factors: (1) capital investments, including foreign direct investment (FDI) and (2) the growth of exports. The results of these qualitative and quantitative analyses lay the foundation for policy recommendations for Vietnam Government to develop economy in the future.

scholarly journals MON-303 Giant Growth Hormone Secreting Pituitary Adenomas: A Single Institution Case Series

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Bahadir Koylu ◽  
Suleyman Nahit Sendur ◽  
Seda Hanife Oguz ◽  
Selcuk Dagdelen ◽  
Tomris A Erbas
Keyword(s):  
Growth Hormone ◽  
Pituitary Adenoma ◽  
Pituitary Adenomas ◽  
Postoperative Radiotherapy ◽  
Somatostatin Receptor ◽  
Case Series ◽  
Tumor Diameter ◽  
Somatostatin Receptor Ligands ◽  
The Mean

Abstract The prevalence of growth hormone (GH)-secreting pituitary adenoma is around 11-13% of all pituitary adenomas. Giant GH-secreting pituitary adenomas (≥ 4 cm) are rare tumors, and its prevalence of among acromegalic patients is &lt;5%. This is a retrospective cohort study including patients with giant GH-secreting pituitary adenomas. The study population consisted of 10 patients (5 M/5 F). The mean age at diagnosis was 33.0±12.9 yrs (11-55 yrs). The mean delay between first symptom onset and diagnosis was 2.9 years. The most frequent symptoms were acral enlargement and facial changes (80%), followed by headache (70%) and visual deterioration (50%). One patient had epilepsy. Amenorrhea was presented in three females but obvious galactorrhea in two. The mean adenoma diameter was 42.6±4.7 mm (40-51 mm) at diagnosis. The vast majority of adenomas presented suprasellar extension (100%) or cavernous sinus invasion (80%). Cystic adenomas accounted for 50%. At presentation, mean GH and IGF-1 levels were 40.0±21.4 ng/mL (14.8-51.0) and 2.62±1.09 x ULN (1.08-3.96), respectively. Six patients presented with PRL cosecretion. At diagnosis maximal tumor diameter was not correlated with GH or IGF-1 levels. All patients underwent pituitary surgery as first-line treatment. Three cases were treated with an endoscopic approach and four cases with a microscopic approach. Transcranial approach was also employed in three cases. Postoperative mean GH and IGF-1 levels were 14.9±16.1 ng/mL (0.6-51.0) and 2.25.±0.82 x ULN (1.48-3.74), respectively. After first surgery, only one patient had more than 50% reduction in IGF-1 levels. Five patients (50%) underwent repeat surgery on two to three procedures because remission was not achieved. Postoperative somatostatin receptor ligands (SRLs) were used by all patients. Six patients were treated with dopamine agonist in combination with SRL. Six patients (60%) received postoperative radiotherapy. The mean follow-up period was 12.6±5.3 yrs (4-21 yrs). The mean GH and IGF-1 levels were 1.47±1.54 ng/mL (0.08-5.25) and 0.73±0.44 x ULN (0.08-1.56), respectively at the last visit. Residual adenoma was present at the last MRI in eight patients (mean diameter 9.0±3.6 mm). Panhypopituitarism rose from 10% at baseline to 30% at the last visit. During follow-up, one patient diagnosed breast cancer, while another diagnosed thyroid papillary cancer. Giant GH-secreting pituitary adenomas can have a clinically aggressive behavior with mass effect. Moreover, treatment in patients with giant GH-secreting pituitary adenoma is complex and multimodal therapy is necessary.

scholarly journals Econometric Assessment of Factors Affecting the Development of Life Insurance in Uzbekistan

2021 ◽  
Vol 11 (2) ◽  
pp. 1123-1138
Author(s):  
Dinora Alisherovna Baratova
Keyword(s):  
Life Insurance ◽  
Insurance Industry ◽  
Theoretical Research ◽  
Insurance Company ◽  
Life Insurance Company ◽  
Factors Affecting ◽  
Factors Influencing ◽  
Main Factors ◽  
Econometric Assessment

This article presents an econometric assessment of the role of the insurance industry in the economy of Uzbekistan and the factors influencing the development of life insurance. It also covers the scientific theoretical research of scientists studying the economics of insurance. In addition, the development of accumulative life insurance in Uzbekistan was econometrically analyzed and Uzbekinvest Life Insurance Company was selected as a sample from the package. The econometric analysis of the development of insurance activities of the insurance company "Uzbekinvest Life" identifies the main factors influencing its development. Factors influencing the development of Uzbekinvest Life insurance company through econometric models were assessed. In addition, proposals were made for the development of funded life insurance in Uzbekistan.

The Factors Affecting Multimedia-Based Inquiry

2009 ◽  
pp. 270-284
Author(s):  
Margus Pedaste ◽  
Tago Sarapuu
Keyword(s):  
Problem Solving ◽  
Inquiry Learning ◽  
Web Based ◽  
Factors Affecting ◽  
Effective Learning ◽  
Software Designers ◽  
Factors Influencing ◽  
Simulation Based ◽  
Level Of Difficulty ◽  
Main Factors

The general aim of the present chapter is to focus on the factors influencing simulation-based computersupported inquiry learning in small groups. The authors will give an overview of research that describes different factors influencing inquiry learning and problem solving and will add a dimension of collaborative web-based inquiry from their studies. The evidence from relevant scientific literature as well as the empirical results collected by the authors form the basis for discussion about designing an effective learning environment through a viewpoint of different end-users of our results – especially teachers and software designers. As a result, three additional main factors have been found that should be taken into account in designing support systems for problem solving: i) the level of difficulty of problems, ii) the appropriate sequence of problems, and iii) the characteristics of learners’ groups.

Structural Analysis of Factors Influencing Quality Innovation Capability in Manufacturing Enterprises

2013 ◽  
Vol 584 ◽  
pp. 268-276
Author(s):  
Wei Hong Li
Keyword(s):  
Innovation System ◽  
Practical Significance ◽  
Structure Model ◽  
Innovation Capability ◽  
Factors Affecting ◽  
Manufacturing Enterprises ◽  
Factors Influencing ◽  
Main Factors ◽  
The Relationship

Through the research on the connotation of quality innovation capability in manufacturing enterprises, 22 factors influencing the quality innovation capability in manufacturing enterprises have been screened out. Based on this, the application of interpretative structural modeling (ISM) has determined the relationship between these factors, establishing the multilevel hierarchical structure model of the main factors affecting the quality innovation capability in manufacturing enterprises, and analyzing the relationships between the five levels of the model and the different roles of each factor that the quality innovation capability of manufacturing enterprises innovation system plays. The results have practical significance for manufacturing enterprises to enhance the quality of innovation capability.

scholarly journals Spatio-temporal variability in the Cladocera assemblage of a subtropical hypersaline lagoon

2022 ◽  
Vol 82 ◽  
Author(s):  
J. C. L. Rosa ◽  
L. L. Batista ◽  
W. M. Monteiro-Ribas
Keyword(s):  
Diversity Index ◽  
Salinity Gradient ◽  
Global Scale ◽  
Hypersaline Environments ◽  
Factors Affecting ◽  
Factors Influencing ◽  
The Mean ◽  
Main Factors ◽  
Spatio Temporal ◽  
Hypersaline Lagoon

Abstract Cladocera represent an important zooplankton group because of their seasonal prominence in terms of abundance and their contribution in controlling primary production (phytoplankton). On a global scale, there are few studies on Cladocera in hypersaline environments. The present work aims to evaluate the spatio-temporal variation of the Cladocera assemblage across a salinity gradient in the habitats of the Araruama Lagoon. Samples were collected in random months over a period of four years at 12 fixed stations in the Araruama Lagoon using a WP2 plankton net equipped with a flow meter. Our results do not reveal significant influence of the tide and seasonal variation as factors affecting the Cladocera assemblage. Five Cladocera species were found in the Araruama Lagoon, only in stations 11 and 12 where they reached an average of 1,799 ± 3,103 ind. m-3. The mean of the Shannon Diversity Index was 0.45 ± 0.2. The species that stood out in terms of frequency and abundance were: Penilia avirostris (frequency of occurrence: 71%), followed by Pseudevadne tergestina (41%). The same species also stood out in terms of relative abundance, Penilia avirostris (87%) and Pseudevadne tergestina (11%). The absence of Cladocera in the innermost parts of the lagoon suggests that their entrance to these locations is possibly inhibited by the salinity and temperature gradient of the lagoon, being the main factors influencing the dynamics of the Cladocera assemblages.

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