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AIM: To systematically review the literature for studies investigating the potential effect of gender of dialysis patients on the immunogenicity of hepatitis B virus vaccines.
METHODS: Literature searches were conducted by the MEDLINE and Google Scholar. The key words used included “hepatitis B (HB)”, “vaccine”, “dialysis”, “hemodialysis”, “sex”, “male” and “female”. Data of seroresponse to HB vaccine in clinical trials regarding sex of the recipients have been achieved and analyzed. Finally data from 19 clinical trials have been pooled and analyzed.
RESULTS: Analysis of response to HB vaccination in our dialysis population showed males significantly respond less to hepatitis B vaccination (P = 0.002, Z = 3.08) with no significant heterogeneity detected [P = 0.766; heterogeneity χ2 = 14.30 (df = 19); I2 = 0%]. A reanalysis of the pooled data was conducted regarding the dialysis mode to evaluate potential differential impact of sex on HB vaccine response. Hemodialysis was the only subgroup that showed a significant difference regarding dialysis mode in response to HB vaccination regarding sex (P = 0.042, Z = 2.03).
CONCLUSION: This Meta-analysis showed significant effect for the sex of chronic kidney disease and dialysis patients on the immunogenicity of HB vaccine. This sex discrimination was most prominent among hemodialysis patients.
Hepatitis B virus vaccination, Hepatitis B virus, Immunogenicity, Dialysis patients, Gender, Sex
Sex bias in response to hepatitis B vaccination in end-stage renal disease patients: Meta-analysis
Hossein Khedmat, Aghdas Aghaei, Mohammad Ebrahim Ghamar-Chehreh, and Shahram Agah
2016 Jan 6
This study is an initial effort to examine the dynamics of efficiency and productivity in Greek public hospitals during the first phase of the crisis 2009-2012. Data were collected by the Ministry of Health after several quality controls ensuring comparability and validity of hospital inputs and outputs. Productivity is estimated using the Malmquist Indicator, decomposing the estimated values into efficiency and technological change.
Hospital efficiency and productivity growth are calculated by bootstrapping the non-parametric Malmquist analysis. The advantage of this method is the estimation efficiency and productivity through the corresponding confidence intervals. Additionally, a Random-effects Tobit model is explored to investigate the impact of contextual factors on the magnitude of efficiency.
Findings reveal substantial variations in hospital productivity over the period from 2009 to 2012. The economic crisis of 2009 had a negative impact in productivity. The average Malmquist Productivity Indicator (MPI) score is 0.72 with unity signifying stable production. Approximately 91% of the hospitals score lower than unity. Substantial increase is observed between 2010 and 2011, as indicated by the average MPI score which fluctuates to 1.52. Moreover, technology change scored more than unity in more than 75% of hospitals. The last period (2011-2012) has shown stabilization in the expansionary process of productivity. The main factors contributing to overall productivity gains are increases in occupancy rates, type and size of the hospital.
This paper attempts to offer insights in efficiency and productivity growth for public hospitals in Greece. The results suggest that the average hospital experienced substantial productivity growth between 2009 and 2012 as indicated by variations in MPI. Almost all of the productivity increase was due to technology change which could be explained by the concurrent managerial and financing healthcare reforms. Hospitals operating under decreasing returns to scale could achieve higher efficiency rates by reducing their capacity. However, certain social objectives should also be considered. Emphasis perhaps should be placed in utilizing and advancing managerial and organizational reforms, so that the benefits of technological improvements will have a continuing positive impact in the future.
Electronic supplementary material
The online version of this article (doi:10.1186/s12962-017-0068-5) contains supplementary material, which is available to authorized users.
Efficiency, Hospitals, Productivity, Malmquist, Tobit, Greece, Crisis
Efficiency and productivity assessment of public hospitals in Greece during the crisis period 2009-2012
P. Xenos,1 J. Yfantopoulos,corresponding author2 M. Nektarios,1 N. Polyzos,3 P. Tinios,1 and A. Constantopoulos2
The presented experiments evaluated the symbiotic performance of soybean genotypes with contrasting salt stress tolerance to arbuscular mycorrhizal fungi (AMF) inoculation. In addition, the physiological stress tolerance mechanisms in plants derived from mutualistic interactions between AMF and the host plants were evaluated. Plant growth, nodulation, nitrogenase activity and levels of endogenous growth hormones, such as indole acetic acid and indole butyric acid, of salt-tolerant and salt-sensitive soybean genotypes significantly decreased at 200 mM NaCl. The inoculation of soybean with AMF improved the symbiotic performance of both soybean genotypes by improving nodule formation, leghemoglobin content, nitrogenase activity and auxin synthesis. AMF colonization also protected soybean genotypes from salt-induced membrane damage and reduced the production of hydrogen peroxide, subsequently reducing the production of TBARS and reducing lipid peroxidation. In conclusion, the results of the present investigation indicate that AMF improve the symbiotic performance of soybean genotypes regardless of their salt stress tolerance ability by mitigating the negative effect of salt stress and stimulating endogenous level of auxins that contribute to an improved root system and nutrient acquisition under salt stress.
Arbuscular mycorrhizal fungi, Glycine max, Auxins, Lipid peroxidation, Nodulation
Comparing symbiotic performance and physiological responses of two soybean cultivars to arbuscular mycorrhizal fungi under salt stress
Abeer Hashem,a,b,⁎ Elsayed Fathi Abd_Allah,c,d Abdulaziz A. Alqarawi,c Stephan Wirth,e and Dilfuza Egamberdievae