Cortisol is a steroid hormone produced in the adrenal cortex and released into circulation. 90% binds to corticoid binding globulin, 8% to albumin, leaving only 1-2% as free, active cortisol. The normal diurnal cycle in humans shows a peak in cortisol levels 60-90 minutes after waking with levels decreasing throughout the day. Assessment of salivary cortisol is useful for monitoring various physiological and pathological conditions due to its correlation with free cortisol levels in plasma. Examples include monitoring stress responses, shift work adaptation, exercise effects, and diagnosing Cushing's disease. Similar diurnal cycles are seen in other mammals like cows.
This document provides information on Cushing's syndrome, including its definition, epidemiology, causes, clinical features, investigations, treatment, and follow-up. Cushing's syndrome results from excess cortisol secretion and can be fatal if left untreated. It is rare, affecting about 2 per million people annually. The causes include pituitary adenomas (68% of cases), ectopic ACTH secretion (12%), and adrenal tumors (18%). Clinical features include weight gain, high blood pressure, and mood disturbances. Investigations involve tests to evaluate cortisol levels and distinguish ACTH-dependent from independent causes. Treatment options are surgery, radiation, medication, and adrenalectomy. Follow-up aims to detect recurrence through monitoring cortisol
Este documento apresenta o prefácio e a introdução de Francis Bacon à sua obra "A sabedoria dos antigos", na qual ele interpreta 31 mitos da Grécia Antiga de forma alegórica para transmitir ideias filosóficas sobre temas como o naturalismo materialista, a distinção entre teologia e ciência, e a importância do progresso humano. O texto contextualiza a abordagem alegórica de Bacon e discute a evolução de suas visões sobre a sabedoria oculta nos mitos ao longo de sua obra.
2024 State of Marketing Report – by HubspotMarius Sescu
https://www.hubspot.com/state-of-marketing
· Scaling relationships and proving ROI
· Social media is the place for search, sales, and service
· Authentic influencer partnerships fuel brand growth
· The strongest connections happen via call, click, chat, and camera.
· Time saved with AI leads to more creative work
· Seeking: A single source of truth
· TLDR; Get on social, try AI, and align your systems.
· More human marketing, powered by robots
ChatGPT is a revolutionary addition to the world since its introduction in 2022. A big shift in the sector of information gathering and processing happened because of this chatbot. What is the story of ChatGPT? How is the bot responding to prompts and generating contents? Swipe through these slides prepared by Expeed Software, a web development company regarding the development and technical intricacies of ChatGPT!
Product Design Trends in 2024 | Teenage EngineeringsPixeldarts
The realm of product design is a constantly changing environment where technology and style intersect. Every year introduces fresh challenges and exciting trends that mold the future of this captivating art form. In this piece, we delve into the significant trends set to influence the look and functionality of product design in the year 2024.
How Race, Age and Gender Shape Attitudes Towards Mental HealthThinkNow
Mental health has been in the news quite a bit lately. Dozens of U.S. states are currently suing Meta for contributing to the youth mental health crisis by inserting addictive features into their products, while the U.S. Surgeon General is touring the nation to bring awareness to the growing epidemic of loneliness and isolation. The country has endured periods of low national morale, such as in the 1970s when high inflation and the energy crisis worsened public sentiment following the Vietnam War. The current mood, however, feels different. Gallup recently reported that national mental health is at an all-time low, with few bright spots to lift spirits.
To better understand how Americans are feeling and their attitudes towards mental health in general, ThinkNow conducted a nationally representative quantitative survey of 1,500 respondents and found some interesting differences among ethnic, age and gender groups.
Technology
For example, 52% agree that technology and social media have a negative impact on mental health, but when broken out by race, 61% of Whites felt technology had a negative effect, and only 48% of Hispanics thought it did.
While technology has helped us keep in touch with friends and family in faraway places, it appears to have degraded our ability to connect in person. Staying connected online is a double-edged sword since the same news feed that brings us pictures of the grandkids and fluffy kittens also feeds us news about the wars in Israel and Ukraine, the dysfunction in Washington, the latest mass shooting and the climate crisis.
Hispanics may have a built-in defense against the isolation technology breeds, owing to their large, multigenerational households, strong social support systems, and tendency to use social media to stay connected with relatives abroad.
Age and Gender
When asked how individuals rate their mental health, men rate it higher than women by 11 percentage points, and Baby Boomers rank it highest at 83%, saying it’s good or excellent vs. 57% of Gen Z saying the same.
Gen Z spends the most amount of time on social media, so the notion that social media negatively affects mental health appears to be correlated. Unfortunately, Gen Z is also the generation that’s least comfortable discussing mental health concerns with healthcare professionals. Only 40% of them state they’re comfortable discussing their issues with a professional compared to 60% of Millennials and 65% of Boomers.
Race Affects Attitudes
As seen in previous research conducted by ThinkNow, Asian Americans lag other groups when it comes to awareness of mental health issues. Twenty-four percent of Asian Americans believe that having a mental health issue is a sign of weakness compared to the 16% average for all groups. Asians are also considerably less likely to be aware of mental health services in their communities (42% vs. 55%) and most likely to seek out information on social media (51% vs. 35%).
This document provides information on Cushing's syndrome, including its definition, epidemiology, causes, clinical features, investigations, treatment, and follow-up. Cushing's syndrome results from excess cortisol secretion and can be fatal if left untreated. It is rare, affecting about 2 per million people annually. The causes include pituitary adenomas (68% of cases), ectopic ACTH secretion (12%), and adrenal tumors (18%). Clinical features include weight gain, high blood pressure, and mood disturbances. Investigations involve tests to evaluate cortisol levels and distinguish ACTH-dependent from independent causes. Treatment options are surgery, radiation, medication, and adrenalectomy. Follow-up aims to detect recurrence through monitoring cortisol
Este documento apresenta o prefácio e a introdução de Francis Bacon à sua obra "A sabedoria dos antigos", na qual ele interpreta 31 mitos da Grécia Antiga de forma alegórica para transmitir ideias filosóficas sobre temas como o naturalismo materialista, a distinção entre teologia e ciência, e a importância do progresso humano. O texto contextualiza a abordagem alegórica de Bacon e discute a evolução de suas visões sobre a sabedoria oculta nos mitos ao longo de sua obra.
2024 State of Marketing Report – by HubspotMarius Sescu
https://www.hubspot.com/state-of-marketing
· Scaling relationships and proving ROI
· Social media is the place for search, sales, and service
· Authentic influencer partnerships fuel brand growth
· The strongest connections happen via call, click, chat, and camera.
· Time saved with AI leads to more creative work
· Seeking: A single source of truth
· TLDR; Get on social, try AI, and align your systems.
· More human marketing, powered by robots
ChatGPT is a revolutionary addition to the world since its introduction in 2022. A big shift in the sector of information gathering and processing happened because of this chatbot. What is the story of ChatGPT? How is the bot responding to prompts and generating contents? Swipe through these slides prepared by Expeed Software, a web development company regarding the development and technical intricacies of ChatGPT!
Product Design Trends in 2024 | Teenage EngineeringsPixeldarts
The realm of product design is a constantly changing environment where technology and style intersect. Every year introduces fresh challenges and exciting trends that mold the future of this captivating art form. In this piece, we delve into the significant trends set to influence the look and functionality of product design in the year 2024.
How Race, Age and Gender Shape Attitudes Towards Mental HealthThinkNow
Mental health has been in the news quite a bit lately. Dozens of U.S. states are currently suing Meta for contributing to the youth mental health crisis by inserting addictive features into their products, while the U.S. Surgeon General is touring the nation to bring awareness to the growing epidemic of loneliness and isolation. The country has endured periods of low national morale, such as in the 1970s when high inflation and the energy crisis worsened public sentiment following the Vietnam War. The current mood, however, feels different. Gallup recently reported that national mental health is at an all-time low, with few bright spots to lift spirits.
To better understand how Americans are feeling and their attitudes towards mental health in general, ThinkNow conducted a nationally representative quantitative survey of 1,500 respondents and found some interesting differences among ethnic, age and gender groups.
Technology
For example, 52% agree that technology and social media have a negative impact on mental health, but when broken out by race, 61% of Whites felt technology had a negative effect, and only 48% of Hispanics thought it did.
While technology has helped us keep in touch with friends and family in faraway places, it appears to have degraded our ability to connect in person. Staying connected online is a double-edged sword since the same news feed that brings us pictures of the grandkids and fluffy kittens also feeds us news about the wars in Israel and Ukraine, the dysfunction in Washington, the latest mass shooting and the climate crisis.
Hispanics may have a built-in defense against the isolation technology breeds, owing to their large, multigenerational households, strong social support systems, and tendency to use social media to stay connected with relatives abroad.
Age and Gender
When asked how individuals rate their mental health, men rate it higher than women by 11 percentage points, and Baby Boomers rank it highest at 83%, saying it’s good or excellent vs. 57% of Gen Z saying the same.
Gen Z spends the most amount of time on social media, so the notion that social media negatively affects mental health appears to be correlated. Unfortunately, Gen Z is also the generation that’s least comfortable discussing mental health concerns with healthcare professionals. Only 40% of them state they’re comfortable discussing their issues with a professional compared to 60% of Millennials and 65% of Boomers.
Race Affects Attitudes
As seen in previous research conducted by ThinkNow, Asian Americans lag other groups when it comes to awareness of mental health issues. Twenty-four percent of Asian Americans believe that having a mental health issue is a sign of weakness compared to the 16% average for all groups. Asians are also considerably less likely to be aware of mental health services in their communities (42% vs. 55%) and most likely to seek out information on social media (51% vs. 35%).
Congestive Heart failure is caused by low cardiac output and high sympathetic discharge. Diuretics reduce preload, ACE inhibitors lower afterload, beta blockers reduce sympathetic activity, and digitalis has inotropic effects. Newer medications target vasodilation and myosin activation to improve heart efficiency while lowering energy requirements. Combination therapy, following an assessment of cardiac function and volume status, is the most effective strategy to heart failure care.
Allopurinol, a uric acid synthesis inhibitor acts by inhibiting Xanthine oxidase competitively as well as non- competitively, Whereas Oxypurinol is a non-competitive inhibitor of xanthine oxidase.
CLASSIFICATION OF H1 ANTIHISTAMINICS-
FIRST GENERATION ANTIHISTAMINICS-
1)HIGHLY SEDATIVE-DIPHENHYDRAMINE,DIMENHYDRINATE,PROMETHAZINE,HYDROXYZINE 2)MODERATELY SEDATIVE- PHENARIMINE,CYPROHEPTADINE, MECLIZINE,CINNARIZINE
3)MILD SEDATIVE-CHLORPHENIRAMINE,DEXCHLORPHENIRAMINE
TRIPROLIDINE,CLEMASTINE
SECOND GENERATION ANTIHISTAMINICS-FEXOFENADINE,
LORATADINE,DESLORATADINE,CETIRIZINE,LEVOCETIRIZINE,
AZELASTINE,MIZOLASTINE,EBASTINE,RUPATADINE. Mechanism of action of 2nd generation antihistaminics-
These drugs competitively antagonize actions of
histamine at the H1 receptors.
Pharmacological actions-
Antagonism of histamine-The H1 antagonists effectively block histamine induced bronchoconstriction, contraction of intestinal and other smooth muscle and triple response especially wheal, flare and itch. Constriction of larger blood vessel by histamine is also antagonized.
2) Antiallergic actions-Many manifestations of immediate hypersensitivity (type I reactions)are suppressed. Urticaria, itching and angioedema are well controlled.3) CNS action-The older antihistamines produce variable degree of CNS depression.But in case of 2nd gen antihistaminics there is less CNS depressant property as these cross BBB to significantly lesser extent.
4) Anticholinergic action- many H1 blockers
in addition antagonize muscarinic actions of ACh. BUT IN 2ND gen histaminics there is Higher H1 selectivitiy : no anticholinergic side effects
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdfOsvaldo Bernardo Muchanga
GASTROINTESTINAL INFECTIONS AND GASTRITIS
Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort.
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)MuskanShingari
Statistics- Statistics is the science of collecting, organizing, presenting, analyzing and interpreting numerical data to assist in making more effective decisions.
A statistics is a measure which is used to estimate the population parameter
Parameters-It is used to describe the properties of an entire population.
Examples-Measures of central tendency Dispersion, Variance, Standard Deviation (SD), Absolute Error, Mean Absolute Error (MAE), Eigen Value
As the world population is aging, Health tourism has become vitally important and will be increased day by day. Because
of the availability of quality health services and more favorable prices as well as to shorten the waiting list for medical
services regionally and internationally. There are some aspects of managing and doing marketing activities in order for
medical tourism to be feasible, in a region called as clustering in a region with main stakeholders groups includes Health
providers, Tourism cluster, etc. There are some related and affecting factors to be considered for the feasibility of medical
tourism within this study such as competitiveness, clustering, Entrepreneurship, SMEs. One of the growth phenomenon
is Health tourism in the city of Izmir and Turkey. The model of five competitive forces of Porter and The Diamond model
that is an economical model that shows the four main factors that affect the competitiveness of a nation and its industries
in this study. The short literature of medical tourism and regional clustering have been mentioned.
Spontaneous Bacterial Peritonitis - Pathogenesis , Clinical Features & Manage...Jim Jacob Roy
In this presentation , SBP ( spontaneous bacterial peritonitis ) , which is a common complication in patients with cirrhosis and ascites is described in detail.
The reference for this presentation is Sleisenger and Fordtran's Gastrointestinal and Liver Disease Textbook ( 11th edition ).
BBB and BCF
control the entry of compounds into the brain and
regulate brain homeostasis.
restricts access to brain cells of blood–borne compounds and
facilitates nutrients essential for normal metabolism to reach brain cells
AI Trends in Creative Operations 2024 by Artwork Flow.pdfmarketingartwork
Creative operations teams expect increased AI use in 2024. Currently, over half of tasks are not AI-enabled, but this is expected to decrease in the coming year. ChatGPT is the most popular AI tool currently. Business leaders are more actively exploring AI benefits than individual contributors. Most respondents do not believe AI will impact workforce size in 2024. However, some inhibitions still exist around AI accuracy and lack of understanding. Creatives primarily want to use AI to save time on mundane tasks and boost productivity.
Organizational culture includes values, norms, systems, symbols, language, assumptions, beliefs, and habits that influence employee behaviors and how people interpret those behaviors. It is important because culture can help or hinder a company's success. Some key aspects of Netflix's culture that help it achieve results include hiring smartly so every position has stars, focusing on attitude over just aptitude, and having a strict policy against peacocks, whiners, and jerks.
Congestive Heart failure is caused by low cardiac output and high sympathetic discharge. Diuretics reduce preload, ACE inhibitors lower afterload, beta blockers reduce sympathetic activity, and digitalis has inotropic effects. Newer medications target vasodilation and myosin activation to improve heart efficiency while lowering energy requirements. Combination therapy, following an assessment of cardiac function and volume status, is the most effective strategy to heart failure care.
Allopurinol, a uric acid synthesis inhibitor acts by inhibiting Xanthine oxidase competitively as well as non- competitively, Whereas Oxypurinol is a non-competitive inhibitor of xanthine oxidase.
CLASSIFICATION OF H1 ANTIHISTAMINICS-
FIRST GENERATION ANTIHISTAMINICS-
1)HIGHLY SEDATIVE-DIPHENHYDRAMINE,DIMENHYDRINATE,PROMETHAZINE,HYDROXYZINE 2)MODERATELY SEDATIVE- PHENARIMINE,CYPROHEPTADINE, MECLIZINE,CINNARIZINE
3)MILD SEDATIVE-CHLORPHENIRAMINE,DEXCHLORPHENIRAMINE
TRIPROLIDINE,CLEMASTINE
SECOND GENERATION ANTIHISTAMINICS-FEXOFENADINE,
LORATADINE,DESLORATADINE,CETIRIZINE,LEVOCETIRIZINE,
AZELASTINE,MIZOLASTINE,EBASTINE,RUPATADINE. Mechanism of action of 2nd generation antihistaminics-
These drugs competitively antagonize actions of
histamine at the H1 receptors.
Pharmacological actions-
Antagonism of histamine-The H1 antagonists effectively block histamine induced bronchoconstriction, contraction of intestinal and other smooth muscle and triple response especially wheal, flare and itch. Constriction of larger blood vessel by histamine is also antagonized.
2) Antiallergic actions-Many manifestations of immediate hypersensitivity (type I reactions)are suppressed. Urticaria, itching and angioedema are well controlled.3) CNS action-The older antihistamines produce variable degree of CNS depression.But in case of 2nd gen antihistaminics there is less CNS depressant property as these cross BBB to significantly lesser extent.
4) Anticholinergic action- many H1 blockers
in addition antagonize muscarinic actions of ACh. BUT IN 2ND gen histaminics there is Higher H1 selectivitiy : no anticholinergic side effects
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdfOsvaldo Bernardo Muchanga
GASTROINTESTINAL INFECTIONS AND GASTRITIS
Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort.
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)MuskanShingari
Statistics- Statistics is the science of collecting, organizing, presenting, analyzing and interpreting numerical data to assist in making more effective decisions.
A statistics is a measure which is used to estimate the population parameter
Parameters-It is used to describe the properties of an entire population.
Examples-Measures of central tendency Dispersion, Variance, Standard Deviation (SD), Absolute Error, Mean Absolute Error (MAE), Eigen Value
As the world population is aging, Health tourism has become vitally important and will be increased day by day. Because
of the availability of quality health services and more favorable prices as well as to shorten the waiting list for medical
services regionally and internationally. There are some aspects of managing and doing marketing activities in order for
medical tourism to be feasible, in a region called as clustering in a region with main stakeholders groups includes Health
providers, Tourism cluster, etc. There are some related and affecting factors to be considered for the feasibility of medical
tourism within this study such as competitiveness, clustering, Entrepreneurship, SMEs. One of the growth phenomenon
is Health tourism in the city of Izmir and Turkey. The model of five competitive forces of Porter and The Diamond model
that is an economical model that shows the four main factors that affect the competitiveness of a nation and its industries
in this study. The short literature of medical tourism and regional clustering have been mentioned.
Spontaneous Bacterial Peritonitis - Pathogenesis , Clinical Features & Manage...Jim Jacob Roy
In this presentation , SBP ( spontaneous bacterial peritonitis ) , which is a common complication in patients with cirrhosis and ascites is described in detail.
The reference for this presentation is Sleisenger and Fordtran's Gastrointestinal and Liver Disease Textbook ( 11th edition ).
BBB and BCF
control the entry of compounds into the brain and
regulate brain homeostasis.
restricts access to brain cells of blood–borne compounds and
facilitates nutrients essential for normal metabolism to reach brain cells
AI Trends in Creative Operations 2024 by Artwork Flow.pdfmarketingartwork
Creative operations teams expect increased AI use in 2024. Currently, over half of tasks are not AI-enabled, but this is expected to decrease in the coming year. ChatGPT is the most popular AI tool currently. Business leaders are more actively exploring AI benefits than individual contributors. Most respondents do not believe AI will impact workforce size in 2024. However, some inhibitions still exist around AI accuracy and lack of understanding. Creatives primarily want to use AI to save time on mundane tasks and boost productivity.
Organizational culture includes values, norms, systems, symbols, language, assumptions, beliefs, and habits that influence employee behaviors and how people interpret those behaviors. It is important because culture can help or hinder a company's success. Some key aspects of Netflix's culture that help it achieve results include hiring smartly so every position has stars, focusing on attitude over just aptitude, and having a strict policy against peacocks, whiners, and jerks.
PEPSICO Presentation to CAGNY Conference Feb 2024Neil Kimberley
PepsiCo provided a safe harbor statement noting that any forward-looking statements are based on currently available information and are subject to risks and uncertainties. It also provided information on non-GAAP measures and directing readers to its website for disclosure and reconciliation. The document then discussed PepsiCo's business overview, including that it is a global beverage and convenient food company with iconic brands, $91 billion in net revenue in 2023, and nearly $14 billion in core operating profit. It operates through a divisional structure with a focus on local consumers.
Content Methodology: A Best Practices Report (Webinar)contently
This document provides an overview of content methodology best practices. It defines content methodology as establishing objectives, KPIs, and a culture of continuous learning and iteration. An effective methodology focuses on connecting with audiences, creating optimal content, and optimizing processes. It also discusses why a methodology is needed due to the competitive landscape, proliferation of channels, and opportunities for improvement. Components of an effective methodology include defining objectives and KPIs, audience analysis, identifying opportunities, and evaluating resources. The document concludes with recommendations around creating a content plan, testing and optimizing content over 90 days.
How to Prepare For a Successful Job Search for 2024Albert Qian
The document provides guidance on preparing a job search for 2024. It discusses the state of the job market, focusing on growth in AI and healthcare but also continued layoffs. It recommends figuring out what you want to do by researching interests and skills, then conducting informational interviews. The job search should involve building a personal brand on LinkedIn, actively applying to jobs, tailoring resumes and interviews, maintaining job hunting as a habit, and continuing self-improvement. Once hired, the document advises setting new goals and keeping skills and networking active in case of future opportunities.
A report by thenetworkone and Kurio.
The contributing experts and agencies are (in an alphabetical order): Sylwia Rytel, Social Media Supervisor, 180heartbeats + JUNG v MATT (PL), Sharlene Jenner, Vice President - Director of Engagement Strategy, Abelson Taylor (USA), Alex Casanovas, Digital Director, Atrevia (ES), Dora Beilin, Senior Social Strategist, Barrett Hoffher (USA), Min Seo, Campaign Director, Brand New Agency (KR), Deshé M. Gully, Associate Strategist, Day One Agency (USA), Francesca Trevisan, Strategist, Different (IT), Trevor Crossman, CX and Digital Transformation Director; Olivia Hussey, Strategic Planner; Simi Srinarula, Social Media Manager, The Hallway (AUS), James Hebbert, Managing Director, Hylink (CN / UK), Mundy Álvarez, Planning Director; Pedro Rojas, Social Media Manager; Pancho González, CCO, Inbrax (CH), Oana Oprea, Head of Digital Planning, Jam Session Agency (RO), Amy Bottrill, Social Account Director, Launch (UK), Gaby Arriaga, Founder, Leonardo1452 (MX), Shantesh S Row, Creative Director, Liwa (UAE), Rajesh Mehta, Chief Strategy Officer; Dhruv Gaur, Digital Planning Lead; Leonie Mergulhao, Account Supervisor - Social Media & PR, Medulla (IN), Aurelija Plioplytė, Head of Digital & Social, Not Perfect (LI), Daiana Khaidargaliyeva, Account Manager, Osaka Labs (UK / USA), Stefanie Söhnchen, Vice President Digital, PIABO Communications (DE), Elisabeth Winiartati, Managing Consultant, Head of Global Integrated Communications; Lydia Aprina, Account Manager, Integrated Marketing and Communications; Nita Prabowo, Account Manager, Integrated Marketing and Communications; Okhi, Web Developer, PNTR Group (ID), Kei Obusan, Insights Director; Daffi Ranandi, Insights Manager, Radarr (SG), Gautam Reghunath, Co-founder & CEO, Talented (IN), Donagh Humphreys, Head of Social and Digital Innovation, THINKHOUSE (IRE), Sarah Yim, Strategy Director, Zulu Alpha Kilo (CA).
Trends In Paid Search: Navigating The Digital Landscape In 2024Search Engine Journal
The search marketing landscape is evolving rapidly with new technologies, and professionals, like you, rely on innovative paid search strategies to meet changing demands.
It’s important that you’re ready to implement new strategies in 2024.
Check this out and learn the top trends in paid search advertising that are expected to gain traction, so you can drive higher ROI more efficiently in 2024.
You’ll learn:
- The latest trends in AI and automation, and what this means for an evolving paid search ecosystem.
- New developments in privacy and data regulation.
- Emerging ad formats that are expected to make an impact next year.
Watch Sreekant Lanka from iQuanti and Irina Klein from OneMain Financial as they dive into the future of paid search and explore the trends, strategies, and technologies that will shape the search marketing landscape.
If you’re looking to assess your paid search strategy and design an industry-aligned plan for 2024, then this webinar is for you.
5 Public speaking tips from TED - Visualized summarySpeakerHub
From their humble beginnings in 1984, TED has grown into the world’s most powerful amplifier for speakers and thought-leaders to share their ideas. They have over 2,400 filmed talks (not including the 30,000+ TEDx videos) freely available online, and have hosted over 17,500 events around the world.
With over one billion views in a year, it’s no wonder that so many speakers are looking to TED for ideas on how to share their message more effectively.
The article “5 Public-Speaking Tips TED Gives Its Speakers”, by Carmine Gallo for Forbes, gives speakers five practical ways to connect with their audience, and effectively share their ideas on stage.
Whether you are gearing up to get on a TED stage yourself, or just want to master the skills that so many of their speakers possess, these tips and quotes from Chris Anderson, the TED Talks Curator, will encourage you to make the most impactful impression on your audience.
See the full article and more summaries like this on SpeakerHub here: https://speakerhub.com/blog/5-presentation-tips-ted-gives-its-speakers
See the original article on Forbes here:
http://www.forbes.com/forbes/welcome/?toURL=http://www.forbes.com/sites/carminegallo/2016/05/06/5-public-speaking-tips-ted-gives-its-speakers/&refURL=&referrer=#5c07a8221d9b
ChatGPT and the Future of Work - Clark Boyd Clark Boyd
Everyone is in agreement that ChatGPT (and other generative AI tools) will shape the future of work. Yet there is little consensus on exactly how, when, and to what extent this technology will change our world.
Businesses that extract maximum value from ChatGPT will use it as a collaborative tool for everything from brainstorming to technical maintenance.
For individuals, now is the time to pinpoint the skills the future professional will need to thrive in the AI age.
Check out this presentation to understand what ChatGPT is, how it will shape the future of work, and how you can prepare to take advantage.
The document provides career advice for getting into the tech field, including:
- Doing projects and internships in college to build a portfolio.
- Learning about different roles and technologies through industry research.
- Contributing to open source projects to build experience and network.
- Developing a personal brand through a website and social media presence.
- Networking through events, communities, and finding a mentor.
- Practicing interviews through mock interviews and whiteboarding coding questions.
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3. Responding effectively to core updates requires analyzing "before and after" data to understand changes, identifying new intents or page types, and ensuring content matches appropriate intents across video, images, knowledge graphs and more.
A brief introduction to DataScience with explaining of the concepts, algorithms, machine learning, supervised and unsupervised learning, clustering, statistics, data preprocessing, real-world applications etc.
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Time Management & Productivity - Best PracticesVit Horky
Here's my presentation on by proven best practices how to manage your work time effectively and how to improve your productivity. It includes practical tips and how to use tools such as Slack, Google Apps, Hubspot, Google Calendar, Gmail and others.
The six step guide to practical project managementMindGenius
The six step guide to practical project management
If you think managing projects is too difficult, think again.
We’ve stripped back project management processes to the
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Unlocking the Power of ChatGPT and AI in Testing - A Real-World Look, present...Applitools
During this webinar, Anand Bagmar demonstrates how AI tools such as ChatGPT can be applied to various stages of the software development life cycle (SDLC) using an eCommerce application case study. Find the on-demand recording and more info at https://applitools.info/b59
Key takeaways:
• Learn how to use ChatGPT to add AI power to your testing and test automation
• Understand the limitations of the technology and where human expertise is crucial
• Gain insight into different AI-based tools
• Adopt AI-based tools to stay relevant and optimize work for developers and testers
* ChatGPT and OpenAI belong to OpenAI, L.L.C.
The document discusses various AI tools from OpenAI like GPT-3 and DALL-E 2, as well as ChatGPT. It explores how search engines are using AI and things to consider around AI-generated content. Potential SEO uses of ChatGPT are also presented, such as generating content at scale, conducting topic research, and automating basic coding tasks. The document encourages further reading on using ChatGPT for SEO purposes.
More than Just Lines on a Map: Best Practices for U.S Bike Routes
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Co-Presenter: Virginia Sullivan Adventure Cycling Association
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Cortisol medicina convencional
1. Cortisol
Physiology
Cortisol is produced in the cortex of the adrenal glands. The lipohilic steroid
hormone is released into the circulation and bound to proteins: 90 % to
corticoid binding globulin (CBG) and 8 % to albumin. Only 1 –2 % of the total
cortisol in the blood is free. Only this part of the cortisol in blood is active on
the target cells. The mentioned facts have to be taken into account by
regarding correlation studies of cortisol in blood and in saliva. At 145 - 180
ng/ml (400 – 500 nmol/l) of total cortisol plasma level the CBG is saturated.
Above this concentration the percentage of free cortisol increases. Therefore
the plasma level of total cortisol depends on the CBG concentration. The
increased CBG level leads to an elevated cortisol plasma level, but to a normal
free cortisol concentration in plasma and saliva. The CBG concentration is
affected by various conditions like pregnancy, liver diseases, inflammation,
polycystic ovary syndrome and application of different drugs (e.g.
contraceptives).
Fig. 22: Correlation of salivary cortisol to cortisol in serum (Vining et al., 1983)
On the left: Relationship between salivary and total serum cortisol in time-matched samples.
On the right: Relationship between salivary and unbound serum cortisol in time-matched
samples.
The release of cortisol is regulated by the corticotropin releasing hormone
(CRH) from the hypothalamus and the adrenocorticotrope hormone (ACTH of
the pituitary gland in a negative feedback mechanism. This release is influenced
by other situations like stress and physical exercise mainly because of the
positive feedback of higher adrenaline levels on the ACTH release.
31
2. The normal cortisol concentration in saliva of humans during the day is
fluctuating with an morning peak 60 to 90 minutes after wake up. The diurnal
cycle of salivary cortisol in healthy adult people is shown in the following graph.
20
Values of 13 females and 8 males
15
Cortisol ng/ml
10
5
0
0 2 4 6 8 10 12 14 16 18
Time after wake up [h]
09.11.00 14:46:01 CORTIDAY.WST
Fig. 23: Diurnal cycle of the salivary cortisol level in relation to the wake-up time.
32
3. In the following table some physiological effects of cortisol are listed.
Effects of Cortisol
• Enhancement of the catabolic part of the lipid and protein
metabolism and the gluconeogenese
• antagonism to insulin
• inhibition of the inflammatory and allergic processes
• enhancement of the contractibility of the heart muscle and
improvement of the peripheric microcirculation
• enhancement of water excretion by the kidneys
• enhancement of the production of gastric juice
• enhancement of the osteoporotic effect within the bones
• enhancement of the excitability in brain regions
• suppression of the hormone secretion of the anterior part of
the pituitary gland (effect on the thyroid gland and the
gonads)
Table 8: Effects of Cortisol in mammalians.
33
4. Indications
In the following table some causes of altered cortisol level are listed.
Causes of Altered
Cortisol Level
Physiological
- elevated during stress situations
- elevated during physical exercises
- elevated by external application of ACTH
- suppressed by application of external corticoids
Pathological
Hypercortisolism (Cushing Syndrome)
- autonomous tumour of the adrenal cortex
- tumour of the pituitary gland (Morbus Cushing,
Cushing Disease)
- ectopic ACTH-Syndrome
Hypocortisolism
- primary insufficiency of the adrenal cortex (Morbus
Addison)
- secondary (pituitary based) insufficiency of the
adrenal cortex
- tertiary (hypothylamic based) insufficiency of the
adrenal cortex
Table 9: Causes of altered cortisol level in mammalians.
Regarding this list it may be concluded that the assessment of cortisol in saliva
is recommended in many questions of various scientific fields like
endocrinology, psychology, sports medicine, pediatrics, anti-aging medicine,
veterinary medicine and others.
Some interesting clinical aspects of the salivary cortisol level are shown in the
following paragraphs:
34
5. Stress research:
In many studies the endocrinological response of people to different kinds of
stress is tested. In order to differentiate peoples reaction there has to be set up
a standardized test which will be applied to all participants. The Trier Social
Stress Test (TSST) is accepted as such an standardized method. If students
perform the TSST every day at the same time for a week they can be divided
into two groups regarding their cortisol level during the assay. The “high
responder” do have an strong increase of the salivary cortisol level repeated
times on following days whereas the “low responder” don’t have this increase.
But in their study Kirschbaum et al. (1995) didn’t find any correlation of the
cortisol concentration to psychological scores.
Fig. 24: Cortisol response on standardized stress situations. Students were exposed to the Trier
Social Stress Test (TSST) between 4 p.m. and 7 p.m. on 5 days (C. Kirschbaum et al., 1995)
35
6. There are hints of some aspects influencing the cortisol reaction on stress in
humans: Gender and in women the menstrual cycle seem to have impact on
this hormone profile and the application of drugs like oral contraceptives seem
to decrease the response of cortisol on stress according to Kirschbaum et al.
(1999).
14 50
Stress 45 Stress
Salivary Free Cortisol (nmol/l)
Total Plasma Cortisol (nmol/l : 10)
12
40
10 35
30
8
25
6 20
4 15
10
2
5
0 0
0 10 20 30 40 50 60 70 80 0 10 20 30 40 50 60 70 80
Time (min.) Time (min.)
Luteal phase (n = 21) Men (n = 20)
Follicular phase (n = 19) OC user (n = 21)
Fig. 25: Impact of gender, menstrual cycle and oral contraceptives during stress on salivary free
cortisol and total plasma cortisol. Healthy men and women run through the Trier Social Stress
Test (TSST). Basal cortisol level are taken the day before (C. Kirschbaum et al., 1999).
Occupational Medicine
Some common issue in community is the adaptation of people to shift work.
There are some people who could bear the change of the working time without
any problems, and others do have psychological difficulties during the
adaptation time.
In some study (Hennig et al. 1998) it is discussed to differentiate these to
groupss of people by the change in the diurnal salivary cortisol profile.
In this study 24 nurses were involved. They collected saliva samples two days
at the early working shift (begin at 6:00 am; end at 9:00 pm) and in the
following 7 nights of the night shift (begin at 9:00 pm; end at 6:00 am).
Salivary cortisol was asessed in each saliva sample.
In figure 26 it is shown that the cortisol morning peak decreased during the
night shift, whereas there developed a “night cortisol peak” at 9:00 pm. At the
fifth night the cortisol of the night peak exceeded that one of the morning peak.
But by looking at the individual cortisol profiles there can be differentiated two
kinds of nurses: By 6 of the 24 cortisol profiles even in the 7th night the night
cortisol peak didn’t exceed the morning peak. These people are called “non-
adapter” in figure 27. These 6 nurses did also report that they have
psychological difficulties during the adaptation period of the night shift.
It is interesting to know if these non-adapter can be converted to adapter when
they are taking melatonin drugs?
36
7. Fig. 26: Diurnal salivary cortisol profile of 24 nurses during two days of the early shift (begin at
6:00 am; end at 9:00 pm) and 7 following days of the night shift (begin at 9:00 pm; end at
6:00 am; J. Hennig et al., 1998)
Fig. 27: Difference of the salivary cortisol concentration of the morning peak and the night peak
of 24 nurses during 7 days of the night shift (begin at 9:00 pm; end at 6:00 am). In 18 nurses
(called “adapter”) after the fifth night the night cortisol peak exceeded the morning peak,
whereas in 6 nurses (called “non-adapter”) this didn’t happen even in the seventh night (J.
Hennig et al., 1998).
37
8. Sports medicine:
During physical exercise like a run it is known that the free salivary cortisol
concentration is increasing followed by an increase of the free testosterone in
man. But there seem to be a difference in the cortisol peak height between well
trained people and so called “non-runners”.
Fig. 28: Salivary cortisol and testosterone level during a marathon run (N. J. Cook et al., 1992)
During Marathon run: • cortisol level (nmol/l) ? testosterone level (pmol/l)
Control Day: ? cortisol level (nmol/l) ? testosterone level (pmol/l)
38
9. 18 180
Cortisol in Saliva Testosterone in Saliva
16 160
Testosterone in Saliva (pg/ml)
14 140
Cortisol in Saliva (ng/ml)
12 120
Begin of
10 Jogging 100
8 80
6 60
4 40
End of
2 20
Jogging
0 0
5:40 PM 6:20 PM 7:00 PM 7:40 PM
Fig. 29: Salivary cortisol and testosterone level during a 5 km run measured with the LIA of IBL-
Hamburg.
39
10. 9
Runners (n = 13) Non-runners (n = 13)
8
7
Salivary Cortisol (ng/ml)
6
5
4
3
2
1
0
Pre-exercise 25 min. of exercise 10 min. post 30 min. post
exercise exercise
Fig. 30: Salivary cortisol response during physical exercise of trained and non-trained people.
(D. L. Rudolph and E. McAuley, 1998). Runners = cross-country runners (ca. 100 km per week
for 2 years); non-runners = students; exercise = 30 min. treadmill run (60 % of max. heart
rate and max. oxygen consumption)
Endocrinology:
Up to now it is sometimes a problem to discriminate the patients with an early
stage of Cushing Disease with healthy persons above all obese humans. Usually
for the endocrine diagnosis an assessment of a diurnal cortisol profile or a
dexamethason suppression function test (1mg Dexamethason applicated at
midnight and taking the sample between 8.00 and 9.00 am.) are performed.
There are some hints that the discrimination between healthy adults and
Cushing syndrome patients is better by assessing the free salivary cortisol levels
than the total plasma cortisol.
40
11. Fig. 31: Saliva and plasma cortisol levels after the Dexamethason-Suppression-Test (Z. Barrou
et al., 1996). Application of 1 mg dexamethasone at midnight and taking the plasma and saliva
samples between 8 and 9 am; Saliva collection with Salivettes.
41
12. It is known that the most important sample by assessing the diurnal cortisol
profile is that one taken at midnight. But the best discrimination will be received
by performing the dexamethason suppression test. These aspects are also
found by using saliva instead of blood.
= non obese persons (n = 30) = Cushing patients (n = 33) = persons with obesity (18)
A. Salivary cortisol level at 9 a.m., 5 p.m. and 11 p.m.
B. Salivary cortisol level between 8 and 9 a.m. after application of 1 mg Dexamethason at midnight
Fig. 32: Saliva cortisol of non-obese and obese persons and of patients with Cushing Disease
(M. Castro et al., 1999)
When traveling from the United States to Europe by plane people will have
during their first week in Europe two cortisol peaks. One at the past morning
time in the United States and the other at the morning in Europe. During the
first week stay in Europe the USA morning peak vanishes and that one of
Europe increases to the normal level. Maybe the time of this endocrine
regulation is related to the jet lag phenomenon in addition to the melatonin
hormone profile.
42
13. 14
Days after arrival from USA (Time shift 9 2nd day 4th day 6th day
12 hrs.):
Salivary Cortisol (ng/ml)
10
8
6
4
2
0
2:00 AM 4:00 AM 6:00 AM 8:00 AM 10:00 AM 12:00 PM 2:00 PM 4:00 PM 6:00 PM 8:00 PM
Fig. 33: Salivary cortisol levels after return to Germany from a Trip from the USA measured with
the Cortisol LIA from IBL-Hamburg.
Veterinary Medicine
In co -operation with the Clinic for Cattle of the Veterinary School
of Hannover, Germany, we assessed the diurnal cortisol profiles of cows. For
this study saliva and blood samples of 5 healthy cows which stayed in the
center for research studies with an artificial rumen fistula were taken. The
saliva samples were collected with Salivettes®, Sarstedt. The sampling intervals
were 30 minutes, beginning at 7:00 am and ending at 4:00 pm.
The cortisol profiles in serum and saliva are shown in figure 34. There is a good
correlation between the serum and saliva cortisol values, but all values do have
a lower level as in humans. It is striking that the cows didn’t have increased
cortisol values in the morning but at noon. Maybe, we didn’t find a morning
peak, because this one might appear earlier in the morning and the cortisol
level at 7:00 am is returned to the baseline value?
Up to now, we don’t have any explanation for the cortisol peak at noon which
appears with the saliva and the serum cortisol, obviously with a great standard
deviation. There was not any stressful event at that time for the cows, like
feeding or milking time or any manipulation by students.
More investigations on this point are necessary.
43
14. 1,6 1,6
1,4 1,4
Serum Cortisol (ng/ml x 100)
Salivary Cortisol (ng/ml)
1,2 1,2
1,0 1,0
0,8 0,8
0,6 0,6
0,4 0,4
0,2 0,2
0,0 0,0
7:00 AM
7:30 AM
8:00 AM
8:30 AM
9:00 AM
9:30 AM
10:00 AM
10:30 AM
11:00 AM
12:00 PM
1:00 PM
2:00 PM
3:00 PM
4:00 PM
Mean Salivary Cortisol (ng/ml) Mean Serum Cortisol (ng/ml x 100)
Fig. 34: Diurnal Profile of cortisol in saliva and serum of 5 healthy cows.
In a second study we collected saliva samples of five bovine patients, which
underwent a surgical operation because of a dislocation of the abomasum to
the left sight at about the same daytime in the late morning.
The saliva samples were collected in Salivettes®, Sarstedt. The day prior to the
operation the samples were collected at the same daytime in 30 minutes
intervals for assessing a baseline cortisol level. Of course, we couldn’t avoid
stress because of the transport and the new surroundings of the cows. At the
day of operation we tried to collect the saliva samples prior to, during and after
the surgical operation.
Some example of a typical cortisol profiles are shown in figure 35.
44
15. 0,6
0,5 Start of Operation
Salivary Cortisol (ng/ml)
0,4
0,3 End of Operation
0,2
0,1
0
9:00 AM 9:30 AM 10:00 AM 10:30 AM 11:00 AM 11:30 AM 12:00 PM
Time
Day of operation Day prior to operation
Fig. 35: Salivary cortisol concentration of a cow which underwent a surgical operation because
of a dislocation of the abomasum to the left compared to the salivary cortisol level of a
reference day.
45
16. In figure 36 we calculated the difference between the salivary cortisol
concentration of the day of the operation and the day before this event for
three cows. It is obvious that the patients react differently on the stress of the
surgical operation independent of the time. There was nearly no difference of
the cortisol level of cow #2 before and during the operation. The cortisol
concentration of cow #5 was increasing long before the start of the operation,
maybe because of some stressful manipulation for the preparation of the
operation. The cortisol level of cow #4 seems to be mainly affected by the
stress of the operation.
0,6
Op. Day minus Ref. Day(ng/ml)
0,4
Difference Cortisol
0,2
0
Start of Operation
-0,2
-100 -50 0 50 100 150
Minutes
Cow #2; Op 70 Min. Cow #4; Op 45 Min. Cow #5; Op 85 Min.
Fig. 36: Difference of the salivary cortisol concentration of three cows, which underwent a
surgical operation because of a dislocation of the abomasum to the left, during the time of
operation and a reference day.
46
17. Normal ranges
In the following the recommended saliva collection panel of some routine
laboratories is given. Of course there are a lot of variations in the collection
schedule for special studies.
Saliva Collection for Cortisol assessment:
Circadian panel: - 4 – 5 samples: immediately after
awaking, noon, 4 pm, 10 pm
(alternatively: 8 pm and midnight)
- to evaluate the morning peak: 4 – 6
samples: immediately after awaking
and every half hour
The following “values” may only be regarded as a guideline. Of course they
depend on the used kit and special population aspects.
Values (ng/ml)
Wake up time 1.4 – 8.9
Peak (within 90 min. after awake) 5.0 – 17.7
3.5 – 4.5 hrs. after cortisol peak 1.0 – 2.8
7.5 – 8.5 hrs. after cortisol peak 0.5 – 3.1
Dexamethason suppression test*
cut off (normal/Cushing Disease) 1.0
borderline 0.7 – 1.6
Addisonian < 0.4
* Application of 1 mg Dexamethason orally at 11 pm; saliva
collection next morning immediately after awaking.
Test Characteristics
The following table summarizes the test characteristics of the Free Cortisol in
Saliva LIA of IBL-Hamburg (cat.no. RE 620 11)
47
18. FREE CORTISOL IN
SALIVA
- LIA -
Principle Competitive Chemiluminescence Immunoassay (LIA)
Format 12 microtiter strips with 8 wells each
Sample 20 µl Saliva
Standards 7 standards, ready for use
0/0.3/0.6/2.0/6.0/15.0/40.0 ng/ml
Incubation 3 hrs. (18 – 24 °C); 10 min. (18 – 24 °C)
Substrate Luminol
Expected values Wake up time 1.4 – 8.9 ng/ml
Cortisol peak
(within 90 min. after wake up) 5.0 – 17.7 ng/ml
3.5 – 4.5 hrs. after cortisol peak 1.0 – 2.8 ng/ml
7.5 – 8.5 hrs. after cortisol peak 0.5 – 3.1 ng/ml
Lit. (RIA):
Addisonian; Dexam. suppr. Test < 0.36 ng/ml
Cushingoid > 7.20 ng/ml
Sensitivity 0.16 ng/ml
Precision Intra assay: 2.9 – 7.7 % at 0.96 – 8.70 ng/ml
Inter assay: 5.7 – 11.7 % at 0.80 – 7.02 ng/ml
Specifity % cross reactivity (Abraham method)
Corticosterone 2.5
Cortisone 2.0
Prednisone 1.0
Controls 2 Saliva kit controls
Automation Assay is tested on different microtiter plate instruments
Cat.-No. RE 620 11
48
19. Comparing this LIA with other immunoassays provided for the assessment of
cortisol in saliva some advantages have to be stressed:
The IBL-Hamburg Cortisol in Saliva LIA has :
- the only FDA clearance as immunoassay for the assessment of saliva
and plasma cortisol concentrations
- a high analytical sensitivity (0.16 ng/ml)
- a good specifity (above all regarding cortisone)
- a good precision (functional sensitivity, see fig. below)
- a good linearity in the clinical relevant concentration range
- two levels of saliva controls included in the kit
- standards, controls and conjugate ready for use
- been applied on automatized instruments
Sensitivity:
In some Cortisol Saliva Assay Characteristics a very good analytical sensitivity is
mentioned (< 0.1 ng/ml). It is important to know that the analytical sensitivity
is evaluated by replicate measurements of the zero standard, which consists of
a buffer solution and not of saliva components!
More interesting is the reproducibility of the cortisol values of saliva samples
(functional sensitivity). Coefficients of variation of replicate measurements
below 10 % in the normal cortisol concentration range (i.e. 0.5 – 17 ng/ml) are
acceptable. In figure 37 you can see that most salivary cortisol immunoassays
don’t fulfil this condition in the low concentration range.
45
Normal Range
40
35
LIA IBL ELISA Competitor 1
30
ELISA Competitor 2 ELISA Competitor 3
C.V. (%)
25 ELISA Competitor 4 RIA Competitor 5
20
15
10
5
0
0 1 2 3 4 5 6 7 8 9 10 11 12 13
Salivary Cortisol (ng/ml)
Fig. 37: Functional Sensitivity of various Cortisol in Saliva Immunoassays
The cortisol level in eight replicates of several saliva samples was measured. In the figure the
coefficients of variation are plotted against the cortisol concentration.
49
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7. Hessl, D. et al. Cortisol and behavior in fragile X syndrome.
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8. Kammerer, M. et al. Pregnant women become insensitive to cold stress.
BMC Pregnancy Childbirth 19: 8, 2002
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50
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24. Cho, K. et al. Chronic Jet Lag Produces Cognitive Deficits. The Journal of
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