A myeloma multiplex kezelési javaslata 2024-ben
How we treat myeloma in 2024
A Myeloma Munkacsoport nevében Varga Gergely foglalja össze, amit 2024 elején legjobb terápiás stratégiának tart a myeloma első, illetve többedvonalas kezelésében. Fontos újdonság, hogy nemcsak a protokollok előírás szerinti alkalmazását mutatjuk be, hanem azt is, hogy – főleg ott, ahol a gyógyszerek piacra kerülése óta sok év eltelt – hogyan lehet annál hatékonyabban, eredményesebben alkalmazni azokat. A lehetőségeknek nyilván az szab határt, hogy a NEAK mit finanszíroz az adott pillanatban. Az írás áttekinti azokat az új kezeléseket is, amik várhatóan a közeljövőben elérhetővé válnak a magyar betegek számára.
Abstract
A key issue that teacher training programmes need to address is how well the contents of various methodology courses translate to in-class uses for pre-service teachers to use during their teaching practices. The paper addresses the problem from multiple angles in a longitudinal project that collected quantitative and qualitative data regarding fourth-year Hungarian pre-service English teachers' views about the practicality and applicability of various EFL methodology course contents. The study found that the key needs pre-service teachers have in connection to the applicability of their course contents corresponds to their developing identities as future teachers. Conclusions are drawn regarding a possible support model utilizing semi-open ended teaching material support and the application possibilities of blended learning.
Abstract
Currently, there are no reported green “high-performance thin-layer chromatography (HPTLC)” methods for domperidone (DOM) and cinnarizine (CNZ) simultaneous detection. The objective of the present study was to design and verify a reverse-phase HPTLC method for the concurrent analysis of CNZ and DOM in commercial tablets that is fast, sensitive, and greener. As a green mobile phase, acetone and water in an 80:20 (v/v) binary ratio were used to simultaneously determine CNZ and DOM. The stationary phase was reverse-phase silica gel 60F254S plates. Concurrent measurements of CNZ and DOM were performed at 230 nm. Four different tools were used to assess the greenness of the current method: AGREE, AES, ChlorTox, and NEMI. For both medications, the current approach was linear in the 25–1,000 ng/band range. The accuracy, precision, robustness, sensitivity, and environmental friendliness of the suggested technique for the CNZ and DOM simultaneous detection were verified. The new method's profile was noticeably greener, as seen by the results of every greenness tool, including NEMI, AES (89), ChlorTox (1.08 g), and AGREE (0.83). Utilizing the current approach, the amount of CNZ and DOM in pharmaceutical tablets was found to be 99.53 and 98.87%, respectively. These findings validate the suitability of the existing method for measuring CNZ and DOM simultaneously in commercial tablets. The results of the proposed study indicated that measuring CNZ and DOM in commercial products could be done consistently with the current methodology.
Abstract
This research investigates the complex interplay between stress impact, concrete shrinkage, and its implications on crack development. Utilizing theoretical and computational methods, the study analyzes the detrimental effects of structural cracks caused by stress variations. A distinctive behavior of long-term shrinkage concerning stress levels was observed. It was found that, positive stress enhances the mean Young's modulus, while negative stress reduces modulus under negative stress conditions, heightened susceptibility to crack propagation under negative stress and improved resistance under positive stress. Temperature's uniform impact on long-term shrinkage is demonstrated, highlighting differences among various cement classes.
Abstract
As instructors in higher education, we are responsible for student learning whether in undergraduate, master's or PhD programs. The extent to which we are successful in this responsibility depends on our ability to design and enact effective instruction. This paper draws on research about learning, particularly the notion of significant learning, as well as a research-based model for designing instruction to propose a range of ways to ensure students actively engage in embedding the knowledge we hope they will.
Abstract
Background
The introduction of Compulsive Sexual Behavior Disorder (CSBD) into the 11th International Classification of Diseases has raised expectations for better treatment options for CSBD. Furthermore, the treatment demand has increased, particularly for pornography use disorder (PUD), a subtype of CSBD. Presumably due to the easy access to Internet pornography an increasing prevalence of PUD is observed. Consequently, providing tailored and effective treatment is essential.
Methods
This article provides an overview of the manualized short-term PornLoS Treatment Program (Pornografienutzungsstörung effektiv behandeln– Leben ohne Suchtdruck; translation: Treating pornography use disorder effectively - life without craving). The program combines 24 individual and 6 group psychotherapy sessions with an interdisciplinary approach by offering a novel treatment framework. This includes, e.g., a mobile app, establishment of self-help groups, and access to other social services such as couple counseling. The cognitive-behavioral treatment program contains interventions addressing psychoeducation, cue exposure, impulse control, cognitive restructuring, emotional regulation, and relapse management.
We here also describe the study protocol of an ongoing four-arm randomized controlled trial. The aim is to test two variants of the PornLoS Treatment Program differing with respect to their treatment goal (abstinence or reduced pornography use) against cognitive-behavioral treatment as usual and against a waitlist control group. The primary outcome is the absence of a PUD diagnosis at the end of therapy. The total target sample size will comprise n = 316 patients with PUD across eight study sites.
Results
The results will be presented at international conferences and published in a scientific peer-reviewed journal.
Abstract
Background and aims
Gambling activity evolves along a continuum from recreational to Gambling Disorder (GD) and a particular challenge is to identify whether there are some neurophysiological particularities already present in gamblers at an early stage. Our main goal was to determine whether, in the gamblers' population, neural responses generated during uncertain decisions were different depending on problematic gambling risk defined by the Canadian Problem Gambling Index (CPGI). We tested the following hypothesis, that the Problem Gambling group would show a different brain activity related to outcomes processing than people with low risk.
Methods
For this purpose, we established a relatively homogeneous population of Online Poker Players divided into two groups according to the CPGI (Low Risk and Problem Gambling). By means of high-density EEG, we compared the spatio-temporal dynamics generated during the completion of the Iowa Gambling Task.
Results
One specific topographic map was observed between 150–175 ms after a negative outcome for both groups, whereas it was displayed in the win condition only for the Problem Gambling group. We found that the Global Field Power of this map was negatively correlated with participants' adherence to a strategy. Source localization identified Anterior Cingulate Cortex and Temporal regions as generators of this map.
Discussion and conclusions
Reward hypersensitivity EEG responses identified in the early outcome process could constitute a potential biomarker of problematic gambling.
Abstract
A fast, accurate, sturdy, and sensitive UPLC-MS/MS method was developed to measure the levels of ADB-BUTINACA in rat plasma for a pharmacokinetic study. The ADB-BUTINACA and midazolam (internal standard) were separated on a UPLC BEH C18 column (2.1 mm × 50 mm, 1.7 μm) using a gradient elution of acetonitrile and water (0.1% formic acid) as the mobile phase. ADB-BUTINACA and midazolam were detected in multiple reaction monitoring (MRM) mode for quantitative analysis, the mass detection was performed on a positive electrospray ionization (ESI) source. The calibration curve displayed excellent linearity from 1 to 1,000 ng mL−1, with a lower limit of quantification of 1.0 ng mL−1 and a limit of detection of 0.3 ng mL−1. The precision for both inter-day and intra-day assays was below 14%, while accuracy ranged from 92% to 111%. The method also showed an average recovery between 87% and 90%, with a matrix effect ranging from 104% to 111%. The data was acceptable according to the guidelines of the US Food and Drug Administration (FDA). This newly validated quantitative method successfully supported the pharmacokinetic study of ADB-BUTINACA.
From passion to knowledge
Plotinus' grades of virtues as stages in the development of practical moral agency
Abstract
In this paper, I aim to situate the practical agency of the sage in an overall picture of the development of the Plotinian moral agent. This development can be seen as a gradual transition from external to internal principles of action guidance which endow the agent with autonomy and coherence in her practical actions. The transition from external to internal principles corresponds to a changing relationship between the agent's telos and particular actions. Non-virtuous agents aim at the attainment of an object of desire, while the civically virtuous person aims to perform virtuous actions irrespectively of the achievement of particular objects of desire. Finally, the telos of the sage is the contemplation of forms and she acts practically as a consequence and external activity of having achieved her goal. The analysis of Plotinus' theory of moral development shows that the sage's inward turn and detachment from external circumstances do not involve inactivity in the practical sphere but figure as a necessary condition of her making an active contribution to the order of the sensible world through her actions as opposed to passively responding to external circumstances.
Abstract
In the confectionery industry large quantities of palm fat in the fillings of chocolate products are used. Based on today's nutritional science results, it is desirable to replace palm oil with healthier fats. Oleogels can provide a kind of solution for this replacement. In our work the rheological, textural and thermal properties of oleogels containing high oleic sunflower oil, beeswax and monoglycerides were determined. In the samples we examined, the gelator concentrations were: 20% beeswax, 15% beeswax and 5% monoglyceride, 10% beeswax and 10% monoglyceride, 5% beeswax and 15% monoglyceride, and 20% monoglyceride. Based on our results, the oleogel containing 15% beeswax and 5% monoglyceride seems an eutectic crystal of beeswaxes and monoglyceride. It has relative high hardness, high storage modulus and high viscosity therefore it can replace the Chocofill filling fat, which contains mainly palm fat, used in large quantities in sweets.
