Internal Medicine - Science topic

Great...

is there any project relevant to rheumatology in your network i will be immensely interested if so

email: shahida.perveen@fui.edu.pk

google scholar account:

I can review for methodology, statistics part in general apart from expertise in public health and internal medicine.

Everybody can find every subject totally free of tuition fees in YOUTUBE videos. If anybody really wishes to learn !?

It would be a pleasure

This question Tung Wah is old question. Hi index should be judged on scale of time, some like David L Morgan and Dean Whitehead suggest no citation is a waste of time. In this aspect like promotion etc it depends how the field |"like" you and if you have ``friends''. In fact, Michael W. Marek suggest that your promotion depends on this number. Yes, it is probably correct to a large extent. I would like to point what happen with time the real good ideas remain and rest is just a dust collection. For example Ohm (from Ohm law) was not cited. I believe there is no physics class today that does not mentioned Ohm law. I would agree that to have a paper that have such a breakthrough is not easy and more likely hard to judge. I believe such idea will even could encounter large resistance. For example, my advisor Eckert introduced dimensional analysis to heat and mass transfer. The critics suggest to burn his book. Even though he was part of the establishment as his advisor Schmidt was a prominent figure in the field. Let me brag a bit. I view my work more on the time scale, as my demonstration that the change of rotation location of ship render the whole work done until now in the field of ship stability as a waste of time. There is no citation on this point. I just notice that people coping my idea without citing it for example, Kostas J. Spyrou copy my stability dome after download my book. So there is effect but in time it will more pronounced.

In summary, in short terms it hi index is important, in the long time range it is not so important.

based on a double-blind, multicenter, RCT comparing 1,000 mg tabs vs 500 mg tabs (same daily dose) in acute hemorrhoid, the authors concluded that "We have been demonstrated that the new single MPFF 1000 mg tablet has clinical acceptability and a good safety profile, comparable to that of MPFF 500 mg tablets. MPFF 1000 mg was as effective as MPFF 500 mg in reducing anal pain and bleeding. The new dose regimen should lead to better treatment adherence and consequently to better management of hemorrhoidal disease."

I would say best specialities for Autistic Doctors would be ones with less pt interaction and more analytical, mathematical and technical details involved like Radiology, Artificial intelligence in Medicine .

Internal Medicine for Autistic Doctors would be misfit....because Internal medicine puts equal emphasis on pt interaction ,social skills and communication skills of Doctor along with medicine analytical skills.

[Job satisfaction and prospects of internal medicine specialists in Austria--an analysis of the profession] - PubMed (nih.gov)

Have a look at this useful RG link for insights.

I personally believe that imaging examinations in covid should be rapid, simple and executable at the patient's bedside and therefore I believe that the most useful is LUS.

Unfortunately still today is used the chest X-ray that has been proven useless.

The purpose of LUS is to stage the pathology in order to predict its evolution, unfavorable or favorable. With LUS and blood gas analysis we can determine which patients should be discharged at home in a period when bed meals are scarce in all hospitals.

Many anti epileptic drugs (AED) are minimally or not bound to serum proteins, are primarily renally cleared or metabolized by non-CYP450 isoenzymes, and/or have less potential to induce/inhibit various hepatic enzyme systems.

Basically renal function test, creatinine clearance, liver function tests should be done so that we can know the dosing and possible pharmacokinetics of the drugs.

Podocytes are highly specialized cells of the kidney glomerulus that wrap around capillaries and that neighbor cells of the Bowman’s capsule. Podocytes play an active role in preventing plasma proteins from entering the urinary ultrafiltrate by providing a barrier comprising filtration slits between foot processes, which in aggregate represent a dynamic network of cellular extensions.

Please go through the following RG links.

The SARS-CoV-2 (Covid-19) coronavirus pandemic is a global epidemic. On a global scale, the state of the pandemic in March 2020 was announced by the World Health Organization. Therefore, this organization could declare the end of the pandemic. On the other hand, the end of the epidemic on a regional, national or local scale can be announced by national central institutions of the health care system, including the ministries of health, in agreement with the government. In order to be able to declare the end of the epidemic on a national, regional or local scale, it is necessary to have a relatively large decrease in the number of new coronavirus infections, a decrease in the number of people seriously ill with Covid-19 disease and deaths caused by this disease. The decrease in Coronavirus infections and in sick people should be sustained in a longer period, i.e. min. several months, taking into account the periods of possible occurrence of subsequent epidemic waves caused by new variants of the Coronavirus and occurring in other regions of the world. In addition, an important factor that may be taken into account in the event of declaring the end of a pandemic on a global scale or an epidemic on a regional scale will be the level of vaccination of citizens with highly effective vaccines against Coronavirus and the level of social, collective immunity of the society achieved thanks to these vaccines.

Best regards,

Dariusz Prokopowicz

CDC considers a person to have a fever when he or she has a measured temperature of 100.4° F (38° C) or greater, or feels warm to the touch, or gives a history of feeling feverish.

https://www.cdc.gov/quarantine/air/reporting-deaths-illness/definitions-symptoms-reportable-illnesses.html#:~:text=CDC%20considers%20a%20person%20to,history%20of%20feeling%20feverish.

I don't think there would be a generic tutorial for analysing a EHR, they are all different and the software should provide help on how to search a topic. Unfortunately coding classifications systems are different across the world and within countries. See that there is considerbale variation of coding and quality. Not even HL7 is uniformly applied in the UK as a health data standard https://en.wikipedia.org/wiki/Health_Level_7 It's a difficult problem.

Cigarette smoking on a regular basis raises erythrocyte count, haemoglobin concentration, and hematocrit.

Dear Seyed Ruhollah Musavinsab. I fully agree with you. But ocassionally patients need to be individualized.Excepting renal failure, I prefer to give drugs at usual interval.

Dear Zahra Khalaf ,

You are right this journal (http://www.sciencepublishinggroup.com/journal/index?journalid=252) is not indexed in the SCIE of Clarivate so it has no impact factor (use this link to check https://mjl.clarivate.com/home ) and is not indexed in Scopus (https://www.scopus.com/sources.uri?zone=TopNavBar&origin=searchbasic ). Besides the big warning sign as mentioned by Mohammed O. Al-Amr , there are more red flags:

-Their indexing page mentioned a lot of the notorious misleading metrics like DRJI, Universal Impact Factor and Eurasian Scientific Journal Index (see also https://beallslist.net/misleading-metrics/ )

-They charge 970 USD for a basically non-indexed journal this is way too high

-Contact info still mentions US address while it is already well-known, they are from Pakistan (https://en.wikipedia.org/wiki/Science_Publishing_Group ). Why hide this you might wonder…

-See also: http://flakyj.blogspot.com/search/label/SciencePG

So, avoid.

Best regards.

It is not always possible to present all data as a graph particularly when there are many different variables of interest in the article, in such cases, a table is required. However, if the variables are few (e.g. number of medications used by the patients in the study), then it is preferable to use graph.

Hi, good day! Nontuberculous mycobacteria are a diverse group of mycobacterial species that causes different clinical infections in children and adults. According to Ingen (2013), 25 species have been strongly associated with NTM out of the 140 known NTM species in the literature/studies. Isolation of M. kansasii and M. malmoense from pulmonary specimens usually indicates disease, whereas Mycobacterium gordonae , M. simiae, or M. chelonae are said to be contaminants rather than causative agents of true disease. Mycobacterium avium complex (MAC), M. xenopi, and M. abscessus form an intermediate category between these two extremes (Ingen,2013). NTM species differ in their clinical relevance therefore, the need for correct species identification is very important. As per your question, to prevent the chance of overdiagnosis and undertreatment of NTM, it is crucial to identify the particular causative agent that caused the condition/illness as well as its clinical relevance. to make a firm diagnosis, a culture of the clinical specimens, and a histological examination of tissue biopsy specimens are needed. Diagnosing NTM disease is complex therefore a good communication between clinicians, radiologists, and microbiologists may help in optimizing the culture conditions in line with the particularities of the patients.

if you want to know more about the diagnosis of NMT, this article might help you:

Ingen, J. (2013). Diagnosis of Nontuberculous Mycobacterial Infections. Diagnosis of Nontuberculous Mycobacterial Infections. DOI:10.1055/s-0033-1333569

Kevin Winston, if you know MS office, then it is so easy, make/draw chart/ graphs etc in MS Excel, and copy/paste to MS Power point as mentioned by Dr. Dariusz Prokopowicz.

Good question

I have the same question. I am planning to do a qualitative inquiry using a phenomenological approach. The planned dissertation is about how first year qualified nurses are constructing their professional identity within governmental hospitals. As I am also a 12 year experienced nurse working in one of the local hospital, I was considering to eliminate the cohort which are allocated in my hospital setting. I wish to have an opinion. Should I include them or exclude them?

Hello, in Portugal, during Covid there was a huge increase of tele consultation. Still some barriers were found:

- older people have more difficulties in using digital tools.

- 3G and 4G coverage is still low in some rural areas.

- Lack of good tele consultation tools available to be used, some physicians then still want to do the face to face consultation.

COVID-19 will increase vascular complications

Coronavirus associated with respiratory distress and ph changes Both Quarantine &Thinking increase stress hormones so more oxidations Limited Exercise will increase blood glucose level

Please see the following RG links.

I am in a contiuous activities during this mandatory vacation but at home office..

Wish you all healthy life.

Yes. He is a prediabetic individual. Why.....?

According to the Michigan Diabetes Center's recordings which were considerably accepted as references by the American Diabetes Association, it classified population using Fasting Plasma Glucose (FPG) into:

euglycemic 72-102 mg/dL

prediabetic 103-125 mg/dL

diabetic ≥ 126 mg/dL

therefore, the second group must be warry via periodic check, good glycemic food control, and body exercises

from my experience point of view, many prediabetic subjects consult my clinic, continuing to have their normal life on my instructions

I will suggest to try to add them back if it fails then contact researchgate.

Great initiative. I will be happy to provide statistical analysis power and research methods...

I have no experience in this field, but i think the following article will be helpful

Best Regards Wesam Salah Mohamed Ibrahim

Thrombocytopenias with the presence of normal functioning thrombocytes may provide some survival advantages for human being since myocardial infarction and stroke are the most common causes of death in developed countries at the moment, and the roles of thrombocytes in such events are significant. Thus initiation of low dose aspirin is strongly advised above the age of 50 years.

In addition to the earlier answers, recent studies suggest very early appendectomy may be associated with autoimmune disease development, including inflammatory bowel disease (IBD), rheumatoid arthritis and lupus. This is probably due to an exaggerated immune response, one that has not been adequately primed for appropriate reaction due to the absent appendix - a seat of lymphoid tissue. The 'hygiene hypothesis' applied to IBD may also be applied to this phenomenon. Further, this indicates a possible role of the appendix in "post-natal" immune tolerance, akin to the role of the thymus in-utero.

The other theory put-forth recently is the protective benefit of appendectomy in preventing neurodegenerative disease. The immune response initiated by the lymphoid tissue in the appendix each time they are stimulated result in free radicals, reactive oxygen species and other metabolic byproducts that have been implicated in the pathogenesis of neurodegenerative diseases including Parkinson's. The model of hepatic encephalopathy is a good comparison.

Dear Ana

Rhinitis is defined as inflammation of the nasal mucosa and is characterized by symptoms of congestion, rhinorrhea, itching of the nose, postnasal drip, and sneezing. It can be divided broadly into two major categories: allergic and nonallergic. Allergic rhinitis is an IgE-mediated inflammation of the nasal passageways triggered by various allergens such as dust, pollens, or molds. Nonallergic rhinitis is characterized by non-IgE-mediated symptoms typical of rhinitis, such as congestion and clear rhinorrhea, with less prominence of sneezing and ocular/nasal pruritis. I suggest that article; for reading ( Allergy Asthma Clin Immunol. 2010; 6(1): 10. ).

You may wish to check on FAO paper on livestock strategy in the region at http://www.fao.org/3/a-mp852e.pdf

Sudan's report for year 2017 on OIE World Animal Health Information System shows that there a number of animal diseases and zoonoses: see the link https://www.oie.int/wahis_2/public/wahid.php/Reviewreport/semestrial/review?year=2017&semester=0&wild=0&country=SDN&this_country_code=SDN&detailed=1

Check as well some of our studies on Sudan:

-

-

I hope this helps you decide which disease and what aspects you can contribute to Sudan's livestock sector through your PhD research.

Nomenclature.

Several:

1. Package insert

2. Physician Desk Reference

3. Online resources of FDA

4. Review published peer-reviewed journal articles

Even I have no previous contacts wuth Cooper China, Cardiac Rehab is an area that my Center and I personally have been involved since several decades ago with broad experience in the education in this field of a lot of foreigners. It will be our pleasure to have the opportunity to get involved in this project.

Thanks for your question.

According to my experience,there is no difference but the patient may be more comfortable when it is reduced

In my opinion, strict limitation is impossible, even meaningless. Maybe rotation departments of family medicine speciality education may give an idea, but on the other hand; the patient spectrum and personal interests in family medicine make such requests meaningless. I believe that the variety of articles in the leading journals of family medicine can be used when defending the discipline.

Since the copyright of an article has to be transferred to the publisher by the author(s) before publication, permission to use a table or a figure has to be requested from the publisher. It must be cited in the legend of the table or figure with reference and "with permission of ...". There is an exception only with public sources, whereby the source must be specified however also exactly.

The clinical picture and ANCA pattern may help....

One has to make certain one has baseline liver enzymes prior to any exposure to aspirin then another set of enzymes post-exposure to aspirin.

Marie Humbert-Claude S. Béatrice Marianne Ewalds-Kvist Thank you for the answers and literature! Will ask more questions with more later when needed.

What is your research about Zahra?

You should consider to have a look at :

Blind people have no visual imagery in their dreams, if born blind. Dreams do process past memories; in a dream, different temporal memory layers can be mixed over into 'one film'. We do not dream with our eyes, it is a brain function in sleep as the brain is a non-stop organ (you could put a light bulb on it).The existence of pre-cognitive dreams, which is portrayed in prophetic literature, e.g. Joseph in Egypt, cannot be ruled out. A healthy sleep cycle (chronobiology) and dreamimg are closely connected, in medical terms, to 'free' the memory from non-necessary psycho-logical ballast of life experiences.

Of course absence of evidence is not evidence of absence (of an effect), and placebo effect is often a default medical position when there is no evidence there might be one!

Indeed the idea that doses of >2000U a day may produce toxicity is mentioned on the basis that it is an oil soluble vitamin that could be stored, but without evidence of this.

I have no answers whether high dose Vit D3 can help CH but I have spoken extensively to endocrinologists on the matter

1. a)10000U a day is very unlikely to produce toxic levels in itself. The danger is related to the potential rise in Serum Ca levels and if this remains normal then there should be no problem with renal stones etc.

b) Vit D deficiency may rarely mask a parathyroid tumour, which can be the cause of increased Serum Ca levels when D3 levels are corrected.

I do not know whether high dose D3 (10000U/d) can produce increased Serum Ca in someone who had previously normal D3 levels, but it seems sensible to monitor it

2. The use of high dose Vit D3 should not be confused with treatment of D3 deficiency. One is using supra-physiological levels of D3 to (possibly) treat CH. The possible mode of action is unclear but may be related to an anti-inflammatory function, but this theory is certainly speculative!

Severe CH is sometimes called Suicide Headache and is debilitating. Perhaps high dose D3 may not be without risks, but with the suffering due to CH and the potential risks of other treatments, perhaps it should be explored further. It is after all a very cheap treatment...

It would be really good to hear more thoughts....

Dear Jakub,

of course it is easier to publish a randomized-controlled study. But there are some other quality characteristics:

- large sample size

- good and complete description of the methods

- good performed statistical analyses

- interesting questions / endpoints and clear study results

- very new results of an interesting new and current topic

I think, you can manage to publish the study!

Best regards

Tanja

Dear Abdallah

The so called "intersticium" is a lymphatic dependent space with very little or no fluid inside it. It was known to anatomists for more than 200 years.

Discovery sometimes is not about discovering something new, but making a big fuzz about old things. Then it seems as a "new discovery".

After answering this question two years ago I did the calculus for the exponential decay curve which occurs after the systolic peak and before the diastolic trough. If the pressure is plotted as log pressure against time you get a straight line (approximately). The slope of this line can be derived. It is proportional to compliance (C) multiplied by resistance (R) of the blood vessels (RC).

I wrote an app for my iPhone in BASIC which was fun to play with in the ICU. Unfortunately I could not find a way to separate the two components R and C and in disease states hardening of the arteries increases resistance and decreases compliance. This means the two factors tend to cancel each other out, making the calculation of RC less sensitive. But the program can help us understand sepsis cases where resistance drops over time.

Some people use the pulse pressure, which is systolic pressure minus diastolic pressure, but this does not take into account the pulse rate. The slower the heart rate the longer the time between the systolic peak and the diastolic trough. This gives more time for the blood pressure to drop off as blood flows away from the heart. Consequently the diastolic pressure drops as heart rate decreases. But if we calculate RC it takes into account all three factors: Systolic Pressure (PS), Diastolic Pressure (DP) and heart rate (HR).

Perhaps I should write an article about this, but who would publish it?

The intent is a mutually beneficial exchange of information and knowledge - so sharing will bring benefits. While the focus is on SAGE and SAGE-related data, we actively encourage comparisons to other data sets and interactions/exchanges on that to better understand the drivers of differences in health created by unique policy and cultural issues.

Hi I'm new in Researchgate and I know your question has already been answered.

But this article published in March 2017 in Nature is about this topic and is very useful to learn more about and gives some warning signs to detect predatory journals.

https://www.nature.com/news/predatory-journals-recruit-fake-editor-1.21662

Thank!

(I hope you will find the correct answers in the appendix section of the manuscript we are writing!)

Did you mean "non-inferior" above re: S-1 & capecitabine? (your first statement).

PG

Dr. Bader,

It depends what you mean by "replenishing deficient cellular energy levels".

One of the characteristics of ischemia in any tissue (but especially heart) is a net loss of 5'-nucleotides.  To replenish these nucleotides (either by de novo synthesis or by salvage synthesis), the cell needs phosphoribosyl pyrophosphate (PRPP) as one of the staring materials.  Ribose is phosphorylated to ribose-1-phosphate, which is then metabolized to PRPP via PRPP synthetase.  Most tissues (aside from liver) have low levels of PRPP synthetase, so the process is slow; however, addition of ribose will enhance nucleoside salvage synthesis in heart two-fold or even more.

Glucose, on the other hand, uses glycolysis and the Krebs cycle to increase ATP levels (and, by proxy, levels of other 5'-nucleotides) via chemiosmosis and the mitochondrial F1-ATPase.  This increase is dependent on the parent molecules for these nucleotides (ADP, CDP, GDP, UDP, TTP) being present.  Glucose will not enhance the levels of these parent molecules, only see to the addition of the final phosphate (an increase in energy charge, but not total cellular levels).

So, ribose and glucose are really doing different things from a cellular point of view.

Cheers,

T. Geisbuhler

Based on TACT trial...ACC recommended chelation therapy as class 2b indication for therapy of stable ischaemic heart disease.. In 2014.Further studies are needed in this aspect. 

 I read your discussion with great interest as it touches the underlying mechanisms of the potential effect that Daith piercing may have on migraines. My background is from biomaterials and I confess immediately that I'm a complete novice in migraine and it's treatment. However, I realised that since the interest in using the piercing as a potential treatment or placebo treatment is high among the patients and apparently some doctors now, there is an opportunity to offer my knowhow for use. Daith piercings have a relatively high complication rate due to the difficult area, type of tissue, piercing models used and lack of standardisation of the actual procedure. No one seems to even know in which exact spot should the piercing be placed to be effective.

Our technology has been developed to alleviate the problems soft tissues have around titanium implants. Basically our material is able to achieve a strong bonding between the cell's and tissues and the implant surface. It is already in use in dental implants and there it's function is to speed up the healing and closure of the gingival tissue wound around the implant, thus reducing the risk of bacteria being able to enter the wound. Other effects observed are that no fibrous encapsulation forms around the implant, inflammatory response is reduced and general healing is improved.

I'm interested in starting a project on the daith piercing, because I read from Dr. Blatchley's internet survey results that exactly these type of complications are common also around the piercings. The goals of the project should be such that the potential treatment would be as safe and effective as the current knowhow already allows. Now, I understand that such project would be foolish to run without the expertise of people like yourselves, because without the understanding of the underlying mechanisms, it would have a high potential going wrong. I wish to therefore ask you all what you think of the potential of Daith piercing as a treatment option. In my mind from an implantology point of view it's a fairly straight forward project. But what are your thoughts on the neurological evidence? what are the main objectives and biggest failure pits?

best regards

Ilkka

Thank you

INR should be measured after 3 days of starting warfarin therapy. After that, measurement is variable between institutions. It an be done every week first and if INR is in the therapeutic range continue every 2 weeks and then every 4 weeks. 

There is a guide: Evidence-Based Management of Anticoagulant Therapy

CHEST 2012; 141(2)(Suppl):e152S–e184S

Yes, milk from animals fed industrial food

45days

The article is not open for reading so it's hard to comment.

Usually "e value" is "expected value"  so there seems to be risk of semantic confusion  

And... No one accused me of being a statistician. But all these kinds of tools are dangerous in the hands of the unwary.  There are ALWAYS built in assumptions such as the underlying distributions are Gaussian or some other silliness.

True

Dear José Antonio,

I remember...NATA Congress, Lisbon 2008! 9 years ago.

I know...publish or perish..

In these years I actually did a lot of studies but I didn't publish them. Thank you  for your exhortation! I'm just writing an article on plasma appropriateness (presented at NATA Congress in Florence)

Dear Jorge Luis,

as you pointed out, the dissolved oxygen in the blood is very important in these cases and is often used in JW with life-threatening anaemia.

Dear Antonio,

I agree with you. It's exciting for me sharing knowledges.

If you are interested, you can find me (and my group voted in Patient Blood management ) on Twitter (@PbmOvestMi), Facebook (@PbmOvestMi) and LinkedIn ( www.linkedin.com/in/ivo-beverina-78385377 )

Best regards to everybody!

Thank you . My comment was not addressed to you, but your response is amazing, I had same question as was asked but some answers were not specific but were helpful

This is a very well known fact, described every where and very easy to confirm in human beings and other mammals. The sinoatrial node (SAN) is the normal pacemaker (origin of cardiac rhythm) and is located in the upper right aspect of the right atrium. The wave-front of depolarization that causes atrial myocardial contraction starts in the right atrial myocardium that is close to the SAN. Independently of intra- atrial specialized conduction fascicles  in human atria, right atrium (RA) starts and complete contraction before Left atrium (LA). 

A very interesting reference in the field is the book: "the conduction system of the heart" edited by Wellens, Lie and Janse.

Best regards,

RA.

FFR-CT is a novel technology that enables determination of the functional significance of lesions noninvasively, using sophisticated computer algorithms based on computational fluid dynamics applied to coronary CTA . There is evidence from several randomized studies, comparing FFR-CT with invasive FFR (representing the gold standard), that FFR-CT can be helpful in evaluation of hemodynamic significance of stenosis, especially in patients with intermediate severity stenosis.

-B.K. Koo The present and future of fractional flow reserve

Circulation Journal, 78 (2014), pp. 1048–1054

-Noninvasive Fractional Flow Reserve Derived From Coronary CT Angiography Clinical Data and Scientific Principles

James K. Min, Charles A. Taylor, Stephan Achenbach, Bon Kwon Koo, Jonathon Leipsic, Bjarne L. Nørgaard, Nico J. Pijls, Bernard De Bruyne JACC: CARDIOVASCULAR IMAGING, VOL. 8, NO. 10, 2015

Noninvasive Fractional Flow Reserve From CT OCTOBER 2015:1209 – 2 2

-Noninvasive FFR derived from coronary CT angiography in the management of coronary artery disease: Technology and clinical update

Matthew Budoff, Rine Nakansihi, Vascular Health and Risk Management 2016;12:269—278

complex interaction between paracetamol and alcohol intak

the acute administration of ethanol inhibits the potentially toxic oxidative metabolism of paracetamol and protects against liver damage. This protection decreased when the concentration of ethanol decreased.the critical period is that the time between ethanol and paracetamol intak

while chronic alcoholism, microsomal enzyme induced with increased toxic metabolic activation of paracetamol and enhanced hepatotoxicity.  elevation of SGOT/SGPT ratio may be 5 times greater than normal

Streptococcal infection is susceptible to natural penicillins. Oropharingeal candidiasis could be a complication of antibiotics therapy, if there is no any other reason( Hiv, inhailed corticosterroids, immune suppressive agents). Anyway there is no need for macrolides  (they are not active against Candida infection and they can cause diarrhea) gastric acid suppression by PPi  can make conditions for candida growth. What's the aim of antihistamines prescription? For candidiasis antifungal drug should be used: fluconasole or nystatin  ( if regisrered) . Second one acts locally on mucosa membrane because it's not absorbed from git. 

And for those who are not aware of ISEV initiatives::

Let your colleagues know about the Annual ISEV2017 Meeting in Toronto! Reach out to those who are and those who might be interested in exosomes, ectosomes and other extracellular vesicles. ISEV2017 is the only global and comprehensive meeting covering the entire field of extracellular vesicle studies.  With each new member, attendee and presenter the ideas become richer, data more exciting, field more mature and the Society stronger. 

https://isev.site-ym.com/page/Membership 

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