Interleukin 1ß, tumour necrosis factor-alpha and interleukin 1 receptor antagonist in newly diagnosed insulin-dependent diabetes mellitus: comparison to long-standing diabetes and healthy individuals

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Glutamine for induction of remission in Crohn's disease.

BACKGROUND: Crohn's disease is a chronic relapsing condition of the alimentary tract with a high morbidity secondary to bowel inflammation. Glutamine plays a key role in maintaining the integrity of the intestinal mucosa and has been shown to reduce inflammation and disease activity in experimental models of Crohn's disease. OBJECTIVES: To evaluate the efficacy and safety of glutamine supplementation for induction of remission in Crohn's disease. SEARCH METHODS: We searched the following databases from inception to November 15, 2015: MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and the Cochrane IBD Group Specialised Register. Study references were also searched for additional trials. There were no language restrictions. SELECTION CRITERIA: Randomised controlled trials (RCTs) that compared glutamine supplementation administered by any route to a placebo, active comparator or no intervention in people with active Crohn's disease were considered for inclusion. DATA COLLECTION AND ANALYSIS: Two authors independently extracted data and assessed the methodological quality of the included studies. The Cochrane risk of bias tool was used to assess methodological quality. The primary outcome measure was clinical or endoscopic remission. Secondary outcomes included intestinal permeability, clinical response, quality of life, growth in children and adverse events. Risk ratios and 95% confidence intervals were calculated for dichotomous outcomes. The overall quality of the evidence supporting the primary outcome was evaluated using the GRADE criteria. MAIN RESULTS: Two small RCTs (total 42 patients) met the inclusion criteria and were included in the review. One study (18 patients) compared four weeks of treatment with a glutamine-enriched polymeric diet (42% amino acid composition) to a standard polymeric diet (4% amino acid composition) with low glutamine content in paediatric patients ( 18 years of age) with acute exacerbation of inflammatory bowel disease. The paediatric study was rated as low risk of bias. The study in adult patients was rated as unclear risk of bias for blinding and low risk of bias for all other items. It was not possible to pool data for meta-analysis because of significant differences in study populations, nature of interventions, and the way outcomes were assessed. Data from one study showed no statistically significant difference in clinical remission rates at four weeks. Forty-four per cent (4/9) of patients who received a glutamine-enriched polymeric diet achieved remission compared to 56% (5/9) of patients who received a standard low-glutamine polymeric diet (RR 0.80, 95% CI 0.31 to 2.04). A GRADE analysis indicated that the overall quality of evidence for this outcome was low due to serious imprecision (9 events). In both included studies, no statistically significant changes in intestinal permeability were found between patients who received glutamine supplementation and those who did not. Neither study reported on clinical response, quality of life or growth in children. Adverse event data were not well documented. There were no serious adverse events in the paediatric study. The study in adult patients reported three central catheter infections with positive blood cultures in the glutamine group compared to none in the control group (RR 7.00, 95% CI 0.40 to 122.44). AUTHORS' CONCLUSIONS: Currently there is insufficient evidence to allow firm conclusions regarding the efficacy and safety of glutamine for induction of remission in Crohn's disease. Data from two small studies suggest that glutamine supplementation may not be beneficial in active Crohn's disease but these results need to be interpreted with caution as they are based on small numbers of patients. This review highlights the need for adequately powered randomised controlled trials to investigate the efficacy and safety of glutamine for induction of remission in Crohn's diseas

Estimering av presskrefter ved mikrotunnelering i varierende grunnforhold

Hensikten med denne masteroppgaven har vært å undersøke ulike metoder for å beregne presskraft som oppstår under mikrotunnelering i varierende grunnforhold. Grunnlag under bakken var delt opp som følgende lag: tørrskropleire, fast silt, bløt leire, fast leire, sand, fast sand og fast leire langs trassen. Mikrotunnelering er en rørpressingsmetode der hydrauliske sylindre presser kuttehode i løsmasser under bakken som trekker med seg andre rør som blir installert underveis. Denne metoden ofte fører til store og unødvendige kostnader og årsaken er at pressgroper er dimensjonert på noen presskrefter som overstiger den faktiske presskraften. Mitt bidrag er å teste noen metoder og hypoteser for beregning av disse krefter langs rørtrassen og gi et godt overslag over de fatktiske kreftene slik at pressgroper kan dimensjoneres mer effektivt. Ved mikrotunnelering oppstår generert presskraft hovedsakelig på grunn av friksjon langs røret og spissmotstand ved rørfronten. Denne kraften påvirkes av flere faktorer, inkludert grunnforhold og prosjektspesifikke variabler som rørdimensjon, trasehelning, bruk av smøremiddel og hyppighet/varighet på stans under pressingen. To metoder for beregning av friksjon og to metoder for beregning av spissmotstand blir undersøkt i denne masteroppgaven, basert på et referanseprosjekt som hadde varierende grunnforhold. På grunn av mangel på informasjon om grunnforhold, grunnundersøkelser....osv, har det blitt anttat flere antakelser. Noe som kunne forventes å føre til noen resultater ikke vil stemme helt med registrerte presskrefter. Disse anatkeslene er troverdige og nøyaktige for de har basert seg på noen standard, Statens vegvesen håndbøker, pensumbøker og tidligere forskninger og tips fra veilederen. En av de foreslåtte modellene for friksjonsberegning er presentert av Ye et al. (2019). Denne modellen ga resultat som ikke stemte helt med registrert presskraft. Det virker som om modellen er sensitiv overfor visse parametere, noe som kan føre til feil i beregningene. En viktig ulempe med denne modellen er at den ikke tar hensyn til omrørt skjærstyrke, noe som kan være en betydelig faktor i norske forhold der det er tilstedeværelse av sensitive masser. I den pågående forskningen er det derfor viktig å forbedre modellene for å gjøre dem mer pålitelige og relevante for norske forhold. Dette kan inkludere å ta hensyn til omrørt skjærstyrke, samt å identifisere og justere de følsomme parametrene som påvirker presskraftberegningene. Ved å gjøre dette vil man kunne øke nøyaktigheten og påliteligheten til beregningene og dermed bidra til bedre planlegging og gjennomføring av mikrotunnelprosjekter i Norge. Den andre tilnærmingen for beregning av friksjon tar utgangspunkt i massenes omrørte skjærfasthet. Det har blitt brukt tre forskjellige hypoteser b,c og d om hvordan massene rundt røret er plassert. Resultatene viser at hypotese c gav et resultat som stemte med de registrete presskrefter mens hypoteser b og d underestimerer de. Når det gjelder spissmotstand, anbefales det å teorien for offshore skjørtpenetrering. Nøyaktige grunnundersøkelser og bestemmelse av geotekniske parametre er nøkkelen til å få gode resultater som stemmer med vikeligheten. Idunn Bue er en tidliger student og har skrevet en masteroppgave om liggnende tema. Masteroppgaven hennes har blitt brukt som hovedreferanse for arbeidet mitt. Det som skiller masteroppgaven min enn hennes er at jeg tester modeller og finner ut presskrefter i varierende grunnforhld og ikke bare for leire som Bue gjorde.The purpose of this master's thesis has been to investigate different methods for calculating the compressive force that occurs during microtunneling in varying ground conditions. The foundation below the ground was divided into the following layers: dry crumbly clay, firm silt, soft clay, firm clay, sand, firm sand and firm clay along the route. Microtunneling is a pipe pressing method where hydraulic cylinders press a cutting head into loose masses under the ground which pulls other pipes that are installed along the way with it. This method often leads to large and unnecessary costs and the reason is that pressure pits are designed for some pressure forces that exceed the actual pressure force. My contribution is to test some methods and hypotheses for calculating these forces along the pipe route and give a good estimate of the actual forces so that pressure pits can be dimensioned more effectively. In microtunneling, the generated pressure force occurs mainly due to friction along the pipe and tip resistance at the pipe front. This force is affected by several factors, including ground conditions and project-specific variables such as pipe dimensions, route slope, use of lubricant and frequency/duration of stops during pressing. Two methods for calculating friction and two methods for calculating tip resistance are investigated in this master's thesis, based on a reference project that had varying basic conditions. Due to a lack of information about ground conditions, ground surveys...etc, several assumptions have been made. Something that could be expected to lead to some results will not agree completely with recorded pressure forces. These anatskeles are credible and accurate because they are based on some standard, Norwegian Road Administration handbooks, syllabus books and previous research and tips from the supervisor. One of the proposed models for friction calculation is presented by Ye et al. (2019). This model produced results that did not fully match the recorded pressure force. It seems that the model is sensitive to certain parameters, which can lead to errors in the calculations. An important disadvantage of this model is that it does not take stirred shear strength into account, which can be a significant factor in Norwegian conditions where there is a presence of sensitive masses. In the ongoing research, it is therefore important to improve the models to make them more reliable and relevant to Norwegian conditions. This may include taking stirred shear strength into account, as well as identifying and adjusting the sensitive parameters that affect the compressive force calculations. By doing this, it will be possible to increase the accuracy and reliability of the calculations and thus contribute to better planning and implementation of microtunnel projects in Norway. The second approach for calculating friction is based on the stirred shear strength of the masses. Three different hypotheses b, c and d have been used about how the masses around the pipe are placed. The results show that hypothesis c gave a result that agreed with the recorded pressure forces, while hypotheses b and d underestimate them. When it comes to tip resistance, the offshore skirt penetration theory is recommended. Accurate ground investigations and the determination of geotechnical parameters are the key to obtaining good results that agree with the reliability. Idunn Bue is a former student and has written a master's thesis on a similar topic. Her master's thesis has been used as the main reference for my work. What distinguishes my master's thesis from hers is that I test models and find out pressure forces in varying basic conditions and not just for clay as Bue did

PENINGKATAN PEMAHAMAN BUDAYA KESELAMATAN DAN KESEHATAN KERJA MELALUI SOSIALISASI IMPLEMENTASI POSTUR KERJA ERGONOMIS

This community service activity aims to increase the understanding of SMK Muhammadiyah Berbah students about the importance of applying ergonomic work postures in learning activities and work practices. Through socialization and training, students are expected to identify the risk of injury due to improper work postures and apply ergonomic principles in their daily activities. Thus, students can maintain personal health and safety and improve the quality of learning and work productivity. The results of this community service journal found that there was an increase in “Keselamatan dan Kesehatan Kerja (K3)” knowledge among SMK Muhammadiyah Berbah students and a significant increase in scores for both genders, with males showing a slightly higher average increase than females. The conclusion from the implementation of these activities is that an increase in knowledge is obtained and efforts to produce students who have competence in the effect of gaining knowledge related to posture at work on long-term occupational health are proven to increase

L’internationalisation des PME marocaines dans la zone UEMOA : mise en évidence des coûts-performances cachés

— Les investissements marocains à l’étranger se sont étoffés grâce à la politique d’ouverture de l’économie marocaine sur le reste du continent Africain. Dans le cadre de sa coopération bilatérale, le Maroc a entrepris des actions afin de développer ses échanges commerciaux et ses investissements dans les pays d’Afrique subsaharienne.L’évolution des investissements directs étrangers du Maroc à destination d’Afrique subsaharienne plus précisément dans la zone de l’Afrique de l’Ouest (UEMOA) (principale zone d’accueil des investissements marocains dans le monde) montre une tendance à la progression, liée à la signature de nombreux accords de protection, de promotion réciproques et de non double imposition, ainsi qu’à l’adoucissement de la règlementation des investissements.  Le concept d’internationalisation /compétitivité des entreprises englobe tous un ensemble d’aspect parmi lequel figure la nécessité de faire une veille, assurer une protection de ces données et asseoir son influence par le biais de l’intelligence économique. Mais également la maitrise des couts de performance cachés qui ne sont pas consignés dans le plan comptable. A cela s’ajoute l’importance d’inclure le facteur humain, aspect prôné par le management socio-économiqueL’objectif de notre recherche est de proposer un cadre d'analyse des déterminants de la compétitivité des PME marocaines qui s'internationalisent dans la zone UEMOA et qui sont à l'épreuve de coûts cachés dans pareil processus d'affaires

Cannabinoid-mediated Epigenetic Regulation of Immune Functions

The cannabinoid system consisting of exogenous and endogenous ligands as well as dedicated receptors has been proposed to play a regulatory role in immune functions. The exogenous cannabinoid Δ9-tetrahydrocannabinol (THC), one of the most widely studied marijuana derivatives, has been associated with multiple anti-inflammatory properties over the years. The majority of THC research has centered on the shift from Th1 to Th2 responses however, the complexity of inflammation has since increased. Recent studies have revealed that epigenome, Th cell subsets, and immunoregulatory cell induction, are all known to impact inflammation. In the current research, we have attempted to look holistically at the impact of THC on inflammation, specifically addressing its effect on epigenome and regulatory cells such as myeloid derived suppressor cells (MDSCs). In regards to epigenetic regulation, we found that THC altered both DNA methylation profiles and microRNA (miRNA, miR) expression in immune cells. THC treatment decreased DNA methylation of key genes, STAT3 and arginase1 (Arg1), associated with the induction and suppressive capabilities of myeloid derived suppressor cells (MDSCs). Furthermore, THC treatment triggered alterations in miRNA expression in lymphocytes, decreasing the differentiation of Th1, via overexpression of miR-29b, and Th17, via reduced miR-21 expression. Moreover, we discovered that THC, a ligand for both CB1 and CB2 cannabinoid receptors, required a fully functional CB1 receptor for optimal induction of MDSCs. Additionally, functional CB1 receptor was necessary for THC to inhibit the Th1 driven proinflammatory response associated with host versus graft disease (HvGD) leading to allogenic graft survival. In order to assess THC inhibition of inflammation, driven by Th1 and Th17, we also used delayed type hypersensitivity (DTH). In this model, THC was able to reduce both Th1 and Th17 associated cytokines and transcription factors. We have further highlighted the importance of the endocannabinoid (EC) system in immunoregulation through the therapeutic use of the endogenous cannabinoid receptor ligand 2-arachidonoyl glycerol (2-AG) and detection of 2-AG during an ongoing DTH response. The impact of endogenous and exogenous cannabinoids and the CB receptors on expressed on immune cells on the regulation of immune response is an exciting area of research with potential implications in the prevention and treatment of inflammatory and autoimmune diseases. Taken together, our findings demonstrate for the first time how cannabinoids can regulate the immune response through alterations in the epigenetic and immunoregulatory pathways, thereby controlling inflammation driven by Th1 and Th17 cells. Our studies shed new light on how cannabinoid system can be targeted to therapeutically prevent and treat inflammatory and autoimmune diseases

Making History: How Art Museums in the French Revolution Crafted a National Identity, 1789-1799

This paper compares two art museums, both created during the French Revolution, that fostered national unity by promoting a cultural identity. By analyzing the use of preexisting architecture from the ancien régime, innovative displays of art and redefinitions of the museum visitor as an Enlightened citizen, this thesis explores the application of eighteenth-century philosophy to the formation of two museums. The first is the Musée Central des Arts in the Louvre and the second is the Musée des Monuments Français, both housed in buildings taken over by the Revolutionary government and present the seized property of the royal family and Catholic Church. Created in a violent and unstable political climate, these museums were an effective means of presenting the First Republic as a guardian of national property and protector of French identity