927 resultados para MCQ, Multiple Choice Tests, Marking Scheme, Negative Marking, On-line Teaching


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Contexto: La eficacia de los cannabinoides en el dolor neuropático es desconocida. El control del dolor es determinante en los pacientes ya que genera un impacto negativo en la calidad de vida de los pacientes. Objetivo: El presente trabajo pretende demostrar la evidencia sobre la eficacia de los medicamentos cannabinoides en el control del dolor neuropático oncológico, mediante la evaluación de la literatura disponible. Metodología: Se realizó una revisión sistemática de literatura incluyendo estudios experimentales, observacionales y revisiones sistemáticas en un periodo de 15 años. Se incluyeron todos los estudios desde el años 2000 con evidencia IB según la escala de evidencia de Oxford. Resultados: Cuatro estudios cumplieron criterios para su inclusión, sin embargo la evidencia es baja y no permite recomendar o descartar los cannabinoides como terapia coadyuvante en control del dolor neuropático oncológico. La combinación de THC/CDB (Sativex®) parece ser un medicamento seguro pues no se reportaron muertes asociadas a su uso, sin embargo la presentación de eventos adversos a nivel gastrointestinal y neurológico podría aumentar el riesgo de interacciones medicamentosas y tener un impacto negativo en la calidad de vida de los pacientes oncológicos. Conclusiones: No hay suficiente literatura y la evidencia no es suficiente para recomendar o descartar el uso de los cannabinoides en dolor neuropático oncológico. Futuros estudios deben realizarse para analizar el beneficio de estos medicamentos. Aunque ética y socialmente hay resistencia para el uso de los cannabinoides, actualmente hay una gran discusión política en el mundo y en Colombia para su aceptación como terapia en el control del dolor.

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Este estudio presenta un análisis exploratorio sobre la correlación entre la fortaleza institucional, las condiciones de paz, y el emprendimiento en una muestra de 23 departamentos en Colombia usando datos de 2014. Para llevar a cabo este objetivo se propusieron y construyeron tres índices siguiendo definiciones conceptuales seminales o estándares de evaluación internacional, a saber: 1) El Índice de Fortaleza Institucional, 2) El Índice de Construcción de Paz (construido a partir del índice de paz negativa y el índice de paz positiva) y 3) El Índice de Emprendimiento Productivo. Los resultados no muestran una correlación significativa entre todos los tres índices. Por un lado, existe una correlación significativa (p<0.05) entre los índices de fortaleza institucional y emprendimiento productivo. Por otro lado, existen correlaciones negativas no significativas entre los índices de paz positiva y fortaleza institucional, emprendimiento productivo y paz positiva y emprendimiento productivo y construcción de paz. En un segundo acercamiento, la población de los departamentos fue la variable con mayor número de correlaciones significativas (p<0.01) entre variables relacionadas con emprendimiento productivo, empleo, producto interno bruto, sofisticación industrial, innovación (patentes) y crimen. Finalmente, se discuten las conclusiones y las futuras investigaciones.

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Introducción: La enfermedad respiratoria ocupacional es causada por la exposición a diferentes agentes en el trabajo. Las pruebas objetivas realizadas en sospecha de enfermedad respiratoria de origen laboral, son importantes herramientas que permiten realizar un adecuado diagnóstico, una detección precoz de la enfermedad respiratoria ocupacional, disminuye el progreso rápido de la patología, la morbilidad de los trabajadores y el impacto negativo sobre su futuro laboral. Objetivo: Caracterizar las pruebas paraclínicas de las patologías respiratorias de trabajadores, en un centro de referencia neumológico de Bucaramanga año 2014-2016. Materiales y métodos: Se realizó un estudio descriptivo retrospectivo con datos secundarios de 96 trabajadores que laboran en diferentes actividades económicas. Se incluyeron variables sociodemográficas, laborales, ayudas imagenológicas y pruebas de función pulmonar, realizando 3 grupos de acuerdo a su patología que fueron: Asma, síndrome de disfunción reactiva de la vía aérea y neumoconiosis. En el análisis estadístico se emplearon medidas de tendencia central y dispersión. Resultados: De los 96 trabajadores 84.4% son hombres, las actividades económicas más frecuentes fueron la industria del petróleo y gas en un 27.1% y trabajadores en materiales de construcción en un 19.8%. En la caracterización paraclínica por grupo de patología, para asma predominó la obstrucción en la espirometría (46.9%) y los volúmenes pulmonares con atrapamiento aéreo (95.5%), en RADS (síndrome de disfunción de vías aéreas reactivas) los volúmenes pulmonares con atrapamiento aéreo (77%) y en las neumoconiosis para Rx de tórax (90.3%) y Tac de tórax (100%) reportaron alteraciones parenquimatosas, espirometría con obstrucción (54.8%) y volúmenes pulmonares con atrapamiento aéreo (62.5 %).Discusión y Conclusiones: Las ocupaciones de mayor riesgo para desarrollo de neumopatías de origen ocupacional fuero, , son la minería y construcción y para asma la agricultura y manufacturas. Para asma se evidenció que no hay significancia diagnóstica para estudios imagenológicos pero sí para las pruebas de función pulmonar. Para neumoconiosis el estudio imagenológico es el de mayor importancia ya que en las radiografías se presentan cambios incluso mucho antes de la afectación de la función pulmonar. Para RADS se concluyó que la realización de un test de provocación con metacolina sería el Gold estándar para el diagnóstico. Las pruebas de función respiratoria son de vital importancia para determinar la enfermedad ocupacional en trabajadores expuestos para vigilancia y detección precoz, es conveniente la realización de protocolos para la evaluación y diagnóstico de la enfermedad respiratoria de origen ocupacional. Palabras claves: Neumoconiosis, asma ocupacional, función pulmonar, radiografía de tórax, ocupación, Colombia.

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Studies have demonstrated that public policies to support private firms’ investment have the ability to promote entrepreneurship, but the sustainability of subsidized firms has not often been analysed. This paper aims to examine this dimension specifically through evaluating the mortality of subsidized firms in the long-term. The analysis focuses on a case study of the LEADER+ Programme in the Alentejo region of Portugal. With this purpose, the paper examines the activity status (active or not active) of 154 private, rural, for-profit firms in Alentejo that had received a subsidy to support investment between 2002 and 2008 under the LEADER+ Programme. The methodology is based on binary choice models in order to study the probability of these firms still being active. The explanatory variables used are the following: (1) the characteristics of entrepreneurs and managers’ strategic decisions, (2) firm profile and characteristics, (3) regional economic environment. Data assessment showed that the cumulative mortality rate of firms on 31st December 2013 is over 20 %. Interpretation of the regression model revealed that he probability of firms’ survival increases with higher investment, firm age and regional business concentration, whereas the number of applications made by firms has a negative impact on their survival. So it seems that for subsidized firms the amount of investment is as important as its frequency.

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Procambarus clarkii is currently recorded from 16 European territories. On top of being a vector of crayfish plague, which is responsible for large-scale disappearance of native crayfish species, it causes severe impacts on diverse aquatic ecosystems, due to its rapid life cycle, dispersal capacities, burrowing activities and high population densities. The species has even been recently discovered in caves. This invasive crayfish is a polytrophic keystone species that can exert multiple pressures on ecosystems. Most studies deal with the decline of macrophytes and predation on several species (amphibians, molluscs, and macroinvertebrates), highlighting how this biodiversity loss leads to unbalanced food chains. At a management level, the species is considered as (a) a devastating digger of the water drainage systems in southern and central Europe, (b) an agricultural pest in Mediterranean territories, consuming, for example, young rice plants, and (c) a threat to the restoration of water bodies in north-western Europe. Indeed, among the high-risk species, P. clarkii consistently attained the highest risk rating. Its negative impacts on ecosystem services were evaluated. These may include the loss of provisioning services such as reductions in valued edible native species of regulatory and supporting services, inducing wide changes in ecological communities and increased costs to agriculture and water management. Finally, cultural services may be lost. The species fulfils the criteria of the Article 4(3) of Regulation (EU) No 1143/2014 of the European Parliament (species widely spread in Europe and impossible to eradicate in a cost-effective manner) and has been included in the “Union List”. Particularly, awareness of the ornamental trade through the internet must be reinforced within the European Community and import and trade regulations should be imposed to reduce the availability of this high-risk species.

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Resumo: O entendimento do fluxo de produção e do aporte de nutrientes via decomposição da serrapilheira e as interações do processo com parâmetros edáficos e ciclagem de nutrientes de espécies nativas da Caatinga têm sido pouco estudados. O conhecimento sobre ciclagem de nutrientes em florestas manejadas também permite inferências sobre as espécies com maior capacidade de reciclagem de nutrientes e seu potencial para recuperação de áreas degradadas. Objetivou-se com isso avaliar a produção e a degradação da serrapilheira de oito espécies lenhosas da Caatinga e mensurar os efeitos de sua aplicação sobre a fertilidade do solo e sobre a produção de sorgo em solo degradado. Para isso realizou-se três ensaios: para o ensaio I quantificou-se a produção de serrapilheira em um delineamento inteiramente casualizado com 6 repetições, por meio da instalação de coletores sob a projeção da copa das espécies (tratamentos): mofumbo, sabiá, jurema-preta, jucá, catingueira, pereiro, pau-branco e marmeleiro, sendo o material coletado mensalmente; foram quantificadas a produção das frações folhas, caule, material reprodutivo, miscelânea e total, bem como o aporte de nutrientes no período chuvoso e seco. Para o ensaio II avaliou-se a taxa de degradação da fração folhas de cada espécie citada por meio da utilização de litter bags, em delineamento inteiramente casualizado com 4 repetições, as coletas foram aos 0, 30, 60, 90, 120 e 150 dias, em seguida quantificou-se os macro e micronutrientes, celulose, lignina e carbono em cada tempo de amostragem. Para o ensaio III, realizou-se experimento em casa de vegetação para mensurar os efeitos da aplicação dos resíduos da serrapilheira das mesmas espécies mencionadas nos ensaios anteriores (I e II) sobre a fertilidade do solo e a produção de sorgo em solo degradado, neste experimento adotou-se o delineamento em blocos casualizados com 5 tratamentos e 5 repetições, sendo avaliadas doses equivalentes a: 0, 15, 30, 60 e 120 kg ha-1 de N dos resíduos de cada espécie e um tratamento adicional com adubação mineral, totalizando 30 unidades experimentais para cada espécie. As variáveis mensuradas foram biométricas, biomassa, teor relativo de clorofila e nitrogênio total, além de análises de fertilidade do solo. Com a análise dos dados verificou-se que a época de maior produção de serrapilheira ocorreu no final do período chuvoso para o início do período seco. A espécie jucá apresentou maior produção de serrapilheira, comparado às outras espécies. O nutriente cálcio apresentou maior acúmulo na serrapilheira para as espécies mofumbo, sabiá, catingueira, pereiro e marmeleiro e o nitrogênio foi superior para as espécies jurema-preta, jucá e pau-branco. Para todas as espécies avaliadas no ensaio de degradação houve redução significativa na sua biomassa em relação ao tempo zero, apresentando a seguinte ordem de velocidade de decomposição: jurema-preta > catingueira > pau-branco > jucá > marmeleiro > mofumbo > pereiro > sabiá. No ensaio de fertilização com os resíduos verificou-se que o marmeleiro promoveu efeitos negativos no solo, como acidificação. Porém, a aplicação dos resíduos da espécie pau-branco foi a que promoveu aumento nos valores de K, SB e CEC do solo e na produção do sorgo os resíduos de jurema-preta e pau-branco foram as que promoveram aumento na massa seca das plantas. Enquanto a adubação mineral proporcionou aumento na produção de massa seca do sorgo, demonstrando que a associação entre adubo mineral e o uso da serrapilheira de espécies da Caatinga pode ser uma opção viável para acelerar a recuperação de solos degradados. Abstract: The understanding of the production flow and nutrient supply via decomposition of litter and process interactions with edaphic parameters and nutrient cycling of native species of the Caatinga has been little studied. The knowledge of nutrient cycling in managed forests also allow inferences about species with capacity greater nutrient recycling capacity and its potential for recovery of degraded areas. This study aimed to evaluate the production and litter degradation 8 woody species of Caatinga and measure the effects of its application on soil fertility and production of sorghum in degraded soil. To this was carried out three tests: for the test I quantified the production of litter in a completely randomized design with 6 replications, by installing collectors under the canopy projection in the species (treatments): mofumbo, sabiá, jurema-preta, jucá, catingueira, pereiro, pau-branco and marmeleiro for each species, and the material collected monthly, were quantified the production of fractions leaves, stem, reproductive material, miscellany and total nutrient intake in the rainy and dry season. For II test evaluated the degradation rate of the fraction leaves through the use of litter bags, in a completely randomized design with 4 replications, the collected was 0, 30, 60, 90, 120 and 150 days and quantitated nutrients, cellulose, lignin and carbon at each evaluation time. For the III test, there was the experiment in a greenhouse to measure the effects of the application of litter waste of the same species of previous tests (I and II) on soil fertility and production of sorghum in degraded soil, was adopted the randomized block design with 5 treatments and 5 replications and evaluated doses equivalent to: 0, 15, 30, 60 and 120 kg ha-1 N of waste each species and an additional treatment with mineral fertilizer, totaling 30 experimental units for each species. Biometric analysis and biomass, relative chlorophyll content and total nitrogen were proceeded. In addition to soil fertility analysis. With the data analysis it was found that the time of greatest litterfall occurred at the end of the rainy season to the beginning of the dry season. The jucá species showed higher production compared to other species. The nutrient calcium had higher accumulation for the species mofumbo, sabiá, catingueira, pereiro and marmeleiro and nitrogen was higher for species jurema-preta, jucá and pau-branco. All species evaluated in degradation test had a significant reduction in biomass over time zero. They presented the following order of decomposition rate: jurema-preta > catingueira > pau-branco > jucá > marmeleiro > mofumbo > pereiro > sabiá. For fertility test it was found that marmeleiro promoted negative effects on soil, such as acidification. However, pau-branco was the specie that promoted further improvements in the K values, SB and CEC to the soil and for the production of sorghum, the waste jurema-preta and pau-branco promoted increase in dry matter plants. While the mineral fertilization provided an increase in dry matter production of sorghum, demonstrating that the combination of mineral fertilizer and the use of litter of Caatinga species may be a viable option to speed up the recovery of degraded soils.

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The issues influencing student engagement with high-stakes computer-based exams were investigated, drawing on feedback from two cohorts of international MA Education students encountering this assessment method for the first time. Qualitative data from surveys and focus groups on the students’ examination experience were analysed, leading to the identification of engagement issues in the delivery of high-stakes computer-based assessments.The exam combined short-answer open-response questions with multiple-choice-style items to assess knowledge and understanding of research methods. The findings suggest that engagement with computer-based testing depends, to a lesser extent, on students’ general levels of digital literacy and, to a greater extent, on their information technology (IT) proficiency for assessment and their ability to adapt their test-taking strategies, including organisational and cognitive strategies, to the online assessment environment. The socialisation and preparation of students for computer-based testing therefore emerge as key responsibilities for instructors to address, with students requesting increased opportunities for practice and training to develop the IT skills and test-taking strategies necessary to succeed in computer-based examinations. These findings and their implications in terms of instructional responsibilities form the basis of a proposal for a framework for Learner Engagement with e-Assessment Practices.

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From its domestication until nowadays, the horse has assumed multiple roles in human society. Over time, this condition and the lack of specific regulation have led to the development of different kinds of management systems for this species. This Ph.D. research project aims to investigate horses' welfare in different management practices and housing systems, considering a multidisciplinary approach, taking into account biological function, naturalness, and affective dimension. The results are presented in five articles that evidence risk factors that can mine horse welfare, and examine tools and parameters that can be employed for its assessment. Our research shows the importance of considering the evolutionary history and the species-specific and behavioural needs of horses in their management and housing. Sociality, free movement, diet composition and foraging routine, and the workload that these animals undergo are important factors that should be taken into account. Furthermore, this research has evidenced the importance of employing different parameters (e.g., behaviour, endocrinological parameters, and immune activity) in welfare assessment and proposes the use of horsehair DHEA (dehydroepiandrosterone) as a possible useful additional non-invasive measure for the investigation of long-term stress conditions. Finally, our results underline the importance of considering the affective dimension in welfare research. Recently, Judgement Bias Tests (JBT), which are based on the influence of affective states on the decision-making process, have been widely employed in animal welfare research. However, our studies show that the use of spatial JBT in horses can have some limitations. Still today several management systems do not fulfill species-specific needs of horses, thus the implementation of specific regulations could ameliorate horse welfare. A multidisciplinary approach to welfare assessment is fundamental, but it should be always remembered the individual and its own characteristics, which can influence not only physiological, immunological, and behavioural responses but also emotional and cognitive dimensions.

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Sales prediction plays a huge role in modern business strategies. One of it's many use cases revolves around estimating the effects of promotions. While promotions generally have a positive effect on sales of the promoted product, they can also have a negative effect on those of other products. This phenomenon is calles sales cannibalisation. Sales cannibalisation can pose a big problem to sales forcasting algorithms. A lot of times, these algorithms focus on sales over time of a single product in a single store (a couple). This research focusses on using knowledge of a product across multiple different stores. To achieve this, we applied transfer learning on a neural model developed by Kantar Consulting to demo an approach to estimating the effect of cannibalisation. Our results show a performance increase of between 10 and 14 percent. This is a very good and desired result, and Kantar will use the approach when integrating this test method into their actual systems.

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Nowadays the idea of injecting world or domain-specific structured knowledge into pre-trained language models (PLMs) is becoming an increasingly popular approach for solving problems such as biases, hallucinations, huge architectural sizes, and explainability lack—critical for real-world natural language processing applications in sensitive fields like bioinformatics. One recent work that has garnered much attention in Neuro-symbolic AI is QA-GNN, an end-to-end model for multiple-choice open-domain question answering (MCOQA) tasks via interpretable text-graph reasoning. Unlike previous publications, QA-GNN mutually informs PLMs and graph neural networks (GNNs) on top of relevant facts retrieved from knowledge graphs (KGs). However, taking a more holistic view, existing PLM+KG contributions mainly consider commonsense benchmarks and ignore or shallowly analyze performances on biomedical datasets. This thesis start from a propose of a deep investigation of QA-GNN for biomedicine, comparing existing or brand-new PLMs, KGs, edge-aware GNNs, preprocessing techniques, and initialization strategies. By combining the insights emerged in DISI's research, we introduce Bio-QA-GNN that include a KG. Working with this part has led to an improvement in state-of-the-art of MCOQA model on biomedical/clinical text, largely outperforming the original one (+3.63\% accuracy on MedQA). Our findings also contribute to a better understanding of the explanation degree allowed by joint text-graph reasoning architectures and their effectiveness on different medical subjects and reasoning types. Codes, models, datasets, and demos to reproduce the results are freely available at: \url{https://github.com/disi-unibo-nlp/bio-qagnn}.

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Urinary tract infection (UTI) is the most common infection posttransplant. However, the risk factors for and the impact of UTIs remain controversial. The aim of this study was to identify the incidence of posttransplant UTIs in a series of renal transplant recipients from deceased donors. Secondary objectives were to identify: (1) the most frequent infectious agents; (2) risk factors related to donor; (3) risk factors related to recipients; and (4) impact of UTI on graft function. This was a retrospective analysis of medical records from renal transplant patients from January to December 2010. Local ethics committee approved the protocol. The incidence of UTI in this series was 34.2%. Risk factors for UTI were older age, (independent of gender), biopsy-proven acute rejection episodes, and kidneys from deceased donors (United Network for Organ Sharing criteria). For female patients, the number of pretransplant pregnancies was an additional risk factor. Recurrent UTI was observed in 44% of patients from the UTI group. The most common infectious agents were Escherichia coli and Klebsiella pneumoniae, for both isolated and recurrent UTI. No difference in renal graft function or immunosuppressive therapy was observed between groups after the 1-year follow-up. In this series, older age, previous pregnancy, kidneys from expanded criteria donors, and biopsy-proven acute rejection episodes were risk factors for posttransplant UTI. Recurrence of UTI was observed in 44%, with no negative impact on graft function or survival.

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Human land use tends to decrease the diversity of native plant species and facilitate the invasion and establishment of exotic ones. Such changes in land use and plant community composition usually have negative impacts on the assemblages of native herbivorous insects. Highly specialized herbivores are expected to be especially sensitive to land use intensification and the presence of exotic plant species because they are neither capable of consuming alternative plant species of the native flora nor exotic plant species. Therefore, higher levels of land use intensity might reduce the proportion of highly specialized herbivores, which ultimately would lead to changes in the specialization of interactions in plant-herbivore networks. This study investigates the community-wide effects of land use intensity on the degree of specialization of 72 plant-herbivore networks, including effects mediated by the increase in the proportion of exotic plant species. Contrary to our expectation, the net effect of land use intensity on network specialization was positive. However, this positive effect of land use intensity was partially canceled by an opposite effect of the proportion of exotic plant species on network specialization. When we analyzed networks composed exclusively of endophagous herbivores separately from those composed exclusively of exophagous herbivores, we found that only endophages showed a consistent change in network specialization at higher land use levels. Altogether, these results indicate that land use intensity is an important ecological driver of network specialization, by way of reducing the local host range of herbivore guilds with highly specialized feeding habits. However, because the effect of land use intensity is offset by an opposite effect owing to the proportion of exotic host species, the net effect of land use in a given herbivore assemblage will likely depend on the extent of the replacement of native host species with exotic ones.

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The aim of this study was to evaluate by clinical and laboratory parameters how cystic fibrosis (CF) affects growth and nutritional status of children who were undergoing CF treatment but did not receive newborn screening. A historical cohort study of 52 CF patients younger than 10 years of age were followed in a reference center in Campinas, Southeast Brazil. Anthropometric measurements were abstracted from medical records until March/2010, when neonatal screening program was implemented. Between September/2009 and March/2010, parental height of the 52 CF patients were also measured. Regarding nutritional status, four patients had Z-scores ≤ -2 for height/age (H/A) and body mass index/age (BMI/A). The following variables were associated with improved H/A ratio: fewer hospitalizations, longer time from first appointment to diagnosis, longer time from birth to diagnosis and later onset of respiratory disease. Forced vital capacity [FVC(%)], forced expiratory flow between 25-75% of FVC [FEF25-75(%)], forced expiratory volume in the first second [FEV1(%)], gestational age, birth weight and early respiratory symptoms were associated with IMC/A. Greater number of hospitalizations, diagnosis delay and early onset of respiratory disease had a negative impact on growth. Lower spirometric values, lower gestational age, lower birth weight, and early onset of respiratory symptoms had negative impact on nutritional status. Malnutrition was observed in 7.7% of cases, but 23% of children had nutritional risk.

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The aim of this study was to evaluate the differential sensitivity of sugarcane genotypes to H2O2 in root medium. As a hypothesis, the drought tolerant genotype would be able to minimize the oxidative damage and maintain the water transport from roots to shoots, reducing the negative effects on photosynthesis. The sugarcane genotypes IACSP94-2094 (drought tolerant) and IACSP94-2101 (drought sensitive) were grown in a growth chamber and exposed to three levels of H2O2 in nutrient solution: control; 3mmolL(-1) and 80mmolL(-1). Leaf gas exchange, photochemical activity, root hydraulic conductance (Lr) and antioxidant metabolism in both roots and leaves were evaluated after 15min of treatment with H2O2. Although, root hydraulic conductance, stomatal aperture, apparent electron transport rate and instantaneous carboxylation efficiency have been reduced by H2O2 in both genotypes, IACSP94-2094 presented higher values of those variables as compared to IACSP94-2101. There was a significant genotypic variation in relation to the physiological responses of sugarcane to increasing H2O2 in root tissues, being root changes associated with modifications in plant shoots. IACSP94-2094 presented a root antioxidant system more effective against H2O2 in root medium, regardless H2O2 concentration. Under low H2O2 concentration, water transport and leaf gas exchange of IACSP94-2094 were less affected as compared to IACSP94-2101. Under high H2O2 concentration, the lower sensitivity of IACSP94-2094 was associated with increases in superoxide dismutase activity in roots and leaves and increases in catalase activity in roots. In conclusion, we propose a general model of sugarcane reaction to H2O2, linking root and shoot physiological responses.

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In this study, we aimed to evaluate the effects of exenatide (EXE) treatment on exocrine pancreas of nonhuman primates. To this end, 52 baboons (Papio hamadryas) underwent partial pancreatectomy, followed by continuous infusion of EXE or saline (SAL) for 14 weeks. Histological analysis, immunohistochemistry, Computer Assisted Stereology Toolbox morphometry, and immunofluorescence staining were performed at baseline and after treatment. The EXE treatment did not induce pancreatitis, parenchymal or periductal inflammatory cell accumulation, ductal hyperplasia, or dysplastic lesions/pancreatic intraepithelial neoplasia. At study end, Ki-67-positive (proliferating) acinar cell number did not change, compared with baseline, in either group. Ki-67-positive ductal cells increased after EXE treatment (P = 0.04). However, the change in Ki-67-positive ductal cell number did not differ significantly between the EXE and SAL groups (P = 0.13). M-30-positive (apoptotic) acinar and ductal cell number did not change after SAL or EXE treatment. No changes in ductal density and volume were observed after EXE or SAL. Interestingly, by triple-immunofluorescence staining, we detected c-kit (a marker of cell transdifferentiation) positive ductal cells co-expressing insulin in ducts only in the EXE group at study end, suggesting that EXE may promote the differentiation of ductal cells toward a β-cell phenotype. In conclusion, 14 weeks of EXE treatment did not exert any negative effect on exocrine pancreas, by inducing either pancreatic inflammation or hyperplasia/dysplasia in nonhuman primates.