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    Structural equation model analysis of the effect of visceral fat on osteoporosis
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    Abstract Background Osteoporosis is a considerable public health challenge in Moyu County, Xinjiang. Here, we evaluated the influencing factors of osteoporosis in this region. Methods We recruited 7,761 participants and randomized them into normal and osteoporotic populations based on T-score. The effects of general conditions, body composition, calcium sources and exercise, respiratory exposure, and daily diet on osteoporosis were analyzed. Furthermore, a structural equation model was constructed to uncover the direct and indirect influencing factors of osteoporosis. Results Among the participants, 1,803 (23.23%) had normal bone mass while 1,496 (19.28%) had osteoporosis. The univariate analysis showed significant differences in the general conditions, body composition, calcium sources and exercise, respiratory exposure, and daily diet. Stratification based on age (45 years) and body mass index (BMI) (18.5 kg/m 2 ) showed variations in the body composition between the two groups; however, the visceral fat differed significantly. Logistic regression analysis affirmed the association of visceral fat index as it was included in all equations, except for age and female menopause. The structural equation exhibited that the general conditions, body composition, and, calcium sources, and exercise were direct factors of osteoporosis, while respiratory exposure and daily diet were indirect factors. The standardized path coefficient was highest in general conditions, followed by body composition, and lastly, calcium sources and exercise. Conclusion Obesity, besides age and female menopause, is also an influencing factor of osteoporosis. The visceral fat index plays a vital role in osteoporosis. Our findings may provide experimental evidence for early prevention and treatment of osteoporosis.
    Seperti pada dewasa, teknik regional anestesi pada pediatrik kini makin popular digunakan oleh ahli anestesikarena keuntungannya. Namun demikian selalu ada risiko dan kemungkinan timbulnya komplikasi dari setiap tindakan yang dilakukan, termasuk tindakan anestesi regional pada pediatrik. Insidensi komplikasi anestesi regional pada pediatrik tidak banyak, dan kalaupun terjadi komplikasi adalah minor. Komplikasi bisa diakibatkan dari identifikasi ruang saraf, alat, obat, teknis tindakan anestesi regionalnya dan komplikasi lainnya.Walaupun tidak banyak kejadian komplikasi regional anestesi yang dilaporkan pada pediatrik, dan bukanlah komplikasi yang fatal, teknik regional anestesi pada pediatrik harus dilakukan dengan lebih hatihati, pertimbangan risiko dan keuntungannya untuk menghindari terjadinya komplikasi, terlebih karena kebanyakan komplikasi dapat dihindari dengan mempelajari teknik yang benar, menggunakan peralatan yang sesuai, dan sangat menerapkan prinsip keamanan pada pasien dengan baik.
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    Genentech is partnering with the German cancer company Affimed to develop immunotherapies for multiple kinds of solid and blood cancers. Affimed is developing therapies that engage natural killer cells of the innate immune system to help direct them to attack cancer cells. Genentech will pay Affimed $96 million up front and up to $5 billion more in potential payments.
    ABSTRACT Airway management is particularly difficult in children with severe congenital anomalies. Such patients are extre- mely sensitive to the respiratory depressant effects of anaesthetic agents. We describe the successful and safe app- lication of caudal anaesthesia for inguinal hernia repair in three cases with severe congenital anomalies (Joubert syndrome, I-cell syndrome). The three patients concerned had congenital anomalies including serious facial defor- mity, respiratory failure and cardiovascular defects. They were administered a single dose of caudal epidural anaest- hesia for inguinal hernia surgery in order to avoid complications associated with general anaesthesia. Caudal block was performed and 1 mL/kg levobupivacaine 0.25% administered. We conclude that caudal epidural anaesthesia can be an effective, suitable and safe anaesthetic technique for inguinal herniotomy without the need for general anaesthesia or endotracheal intubation in children with severe congenital anomalies.  Key Words: Caudal anaesthesia, children, congenital anomaly OZET Havayolu yonetimi, ciddi konjenital anomalileri olan cocuklarda ozellikle zordur. Bu tur hastalar anestezik ilaclarin solunum depresan etkilerine karsi asiri derecede duyarlidir. Kaudal anestezinin inguinal herni onarimindaki basarili ve guvenli uygulamasi konjenital anomalileri (Joubert sendromu, I-cell hastaligi) olan uc olguda gosterilmistir. Ilgili uc cocuk hastada, ciddi yuz deformitesi, solunum yetmezligi ve kardiyovaskuler bozukluk dahil konjenital bozuk- luklar vardi. Genel anesteziyle iliskili komplikasyonlari onlemek icin inguinal herni cerrahisinde tek doz kaudal epi- dural anestezi uygulandi. Kaudal anestezide %0.25 levobupivakain 1 mL/kg kullanildi. Kaudal epidural anestezinin, ciddi konjenital bozukluklari olan cocuklarda inguinal herni onarimi acisindan genel anesteziye veya endotrakeal entubasyona gerek duyulmadan etkili, uygun ve guvenli bir alternatif anestezi teknigi olabilecegi sonucuna varildi.  A na h ta r Sozcukler: Kaudal anestezi, cocuk, konjenital bozukluk
    Levobupivacaine
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    The nationally-recognized Susquehanna Chorale will delight audiences of all ages with a diverse mix of classic and contemporary pieces. The ChoraleAƒÂƒA‚ƒAƒÂ‚A‚ƒAƒÂƒA‚‚AƒÂ‚A‚ƒAƒÂƒA‚ƒAƒÂ‚A‚‚AƒÂƒA‚‚AƒÂ‚A‚ƒAƒÂƒA‚ƒAƒÂ‚A‚ƒAƒÂƒA‚‚AƒÂ‚A‚‚AƒÂƒA‚ƒAƒÂ‚A‚‚AƒÂƒA‚‚AƒÂ‚A‚¢AƒÂƒA‚ƒAƒÂ‚A‚ƒAƒÂƒA‚‚AƒÂ‚A‚ƒAƒÂƒA‚ƒAƒÂ‚A‚‚AƒÂƒA‚‚AƒÂ‚A‚‚AƒÂƒA‚ƒAƒÂ‚A‚ƒAƒÂƒA‚‚AƒÂ‚A‚‚AƒÂƒA‚ƒAƒÂ‚A‚‚AƒÂƒA‚‚AƒÂ‚A‚€AƒÂƒA‚ƒAƒÂ‚A‚ƒAƒÂƒA‚‚AƒÂ‚A‚ƒAƒÂƒA‚ƒAƒÂ‚A‚‚AƒÂƒA‚‚AƒÂ‚A‚‚AƒÂƒA‚ƒAƒÂ‚A‚ƒAƒÂƒA‚‚AƒÂ‚A‚‚AƒÂƒA‚ƒAƒÂ‚A‚‚AƒÂƒA‚‚AƒÂ‚A‚™s performances have been described as AƒÂƒA‚ƒAƒÂ‚A‚ƒAƒÂƒA‚‚AƒÂ‚A‚ƒAƒÂƒA‚ƒAƒÂ‚A‚‚AƒÂƒA‚‚AƒÂ‚A‚ƒAƒÂƒA‚ƒAƒÂ‚A‚ƒAƒÂƒA‚‚AƒÂ‚A‚‚AƒÂƒA‚ƒAƒÂ‚A‚‚AƒÂƒA‚‚AƒÂ‚A‚¢AƒÂƒA‚ƒAƒÂ‚A‚ƒAƒÂƒA‚‚AƒÂ‚A‚ƒAƒÂƒA‚ƒAƒÂ‚A‚‚AƒÂƒA‚‚AƒÂ‚A‚‚AƒÂƒA‚ƒAƒÂ‚A‚ƒAƒÂƒA‚‚AƒÂ‚A‚‚AƒÂƒA‚ƒAƒÂ‚A‚‚AƒÂƒA‚‚AƒÂ‚A‚€AƒÂƒA‚ƒAƒÂ‚A‚ƒAƒÂƒA‚‚AƒÂ‚A‚ƒAƒÂƒA‚ƒAƒÂ‚A‚‚AƒÂƒA‚‚AƒÂ‚A‚‚AƒÂƒA‚ƒAƒÂ‚A‚ƒAƒÂƒA‚‚AƒÂ‚A‚‚AƒÂƒA‚ƒAƒÂ‚A‚‚AƒÂƒA‚‚AƒÂ‚A‚œemotionally unfiltered, honest music making, successful in their aim to make the audience feel, to be moved, to be part of the performance - and all this while working at an extremely high musical level.AƒÂƒA‚ƒAƒÂ‚A‚ƒAƒÂƒA‚‚AƒÂ‚A‚ƒAƒÂƒA‚ƒAƒÂ‚A‚‚AƒÂƒA‚‚AƒÂ‚A‚ƒAƒÂƒA‚ƒAƒÂ‚A‚ƒAƒÂƒA‚‚AƒÂ‚A‚‚AƒÂƒA‚ƒAƒÂ‚A‚‚AƒÂƒA‚‚AƒÂ‚A‚¢AƒÂƒA‚ƒAƒÂ‚A‚ƒAƒÂƒA‚‚AƒÂ‚A‚ƒAƒÂƒA‚ƒAƒÂ‚A‚‚AƒÂƒA‚‚AƒÂ‚A‚‚AƒÂƒA‚ƒAƒÂ‚A‚ƒAƒÂƒA‚‚AƒÂ‚A‚‚AƒÂƒA‚ƒAƒÂ‚A‚‚AƒÂƒA‚‚AƒÂ‚A‚€AƒÂƒA‚ƒAƒÂ‚A‚ƒAƒÂƒA‚‚AƒÂ‚A‚ƒAƒÂƒA‚ƒAƒÂ‚A‚‚AƒÂƒA‚‚AƒÂ‚A‚‚AƒÂƒA‚ƒAƒÂ‚A‚ƒAƒÂƒA‚‚AƒÂ‚A‚‚AƒÂƒA‚ƒAƒÂ‚A‚‚AƒÂƒA‚‚AƒÂ‚A‚ Experience choral singing that will take you to new heights!
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