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11/13/2024


© 2020 Blackwell Verlag GmbH.Agricultural expansion encroaches on tropical forests and primates in such landscapes frequently incorporate crops into their diet. Understanding the nutritional drivers behind crop-foraging can help inform conservation efforts to improve human-primate coexistence. This study builds on existing knowledge of primate diets in anthropogenic landscapes by estimating the macronutrient content of 24 wild and 11 cultivated foods (90.5% of food intake) consumed by chimpanzees (Pan troglodytes verus) at Bossou, Guinea, West Africa. We also compared the macronutrient composition of Bossou crops to published macronutrient measures of crops from Bulindi, Uganda, East Africa. The composition of wild fruits, leaves, and pith were consistent with previous reports for primate diets. Cultivated fruits were higher in carbohydrates and lower in insoluble fiber than wild fruits, while wild fruits were higher in protein. Macronutrient content of cultivated pith fell within the ranges of consumed wild pith. Oil palm food parts were relatively rich in carbohydrates, protein, lipids, and/or fermentable fiber, adding support for the nutritional importance of the oil palm for West African chimpanzees. We found no differences in the composition of cultivated fruits between Bossou and Bulindi, suggesting that macronutrient content alone does not explain differences in crop selection. Our results build on the current understanding of chimpanzee feeding ecology within forest-agricultural mosaics and provide additional support for the assumption that crops offer primates energetic benefits over wild foods. © 2020 Wiley Periodicals, Inc.PURPOSE In 2004, Boumezbeur et al proposed a simple yet powerful approach to detect the metabolism of 13 C-enriched substrates in the brain. Their approach consisted of dynamic 1 H-MRS, without a 13 C radiofrequency (RF) channel, and its successful application was demonstrated in monkeys. Since then, this promising method has yet to be applied rigorously in humans. In this study, we revisit the use of dynamic 1 H-MRS to measure the metabolism of 13 C-enriched substrates and demonstrate its application in the human brain. METHODS In healthy participants, 1 H-MRS data were acquired dynamically before and following a bolus infusion of [1-13 C] glucose. Data were acquired on a 3T clinical MRI scanner using a short-TE SPECIAL sequence, with regions of interest in both anterior and posterior cingulate cortex. Using simulated basis spectra to model signal changes in both 12 C-bonded and 13 C-coupled resonances, the acquired spectra were fit in LCModel to obtain labeling time courses for glutmate and glutamine at both C4 and C3 positions. RESULTS Presence of the 13 C label was clearly detectable, owing to the pronounced effect of heteronuclear (13 C-1 H) scalar coupling on the observed 1 H spectra. A decrease in signal from 12 C-bonded protons and an increase in signal from 13 C-coupled protons were observed. The fractional enrichment of Glu-C4, (Glu+Gln)-C4, and (Glu+Gln)-C3 at 30 minutes following infusion of [1-13 C] glucose was similar in both regions 11% to 13%, 9% to 12% and 3% to 5%, respectively. CONCLUSION These preliminary results confirm the feasibility of the use of dynamic 1 H-MRS to monitor 13 C labeling in the human brain, without a 13 C RF channel. © 2020 International Society for Magnetic Resonance in Medicine.OBJECTIVES The aim of the study was to examine the prevalence of third molars in panoramic radiographs in a population-based study of adults aged ≥30 years. METHODS Out of a sample of 8028 inhabitants of Finland, selected with two-staged stratified cluster-sampling method for the Health 2000 Survey, 5989 participated in clinical oral examination and panoramic radiography. Mean age was 52.5 years (SD 14.6; range 30-97 years). The following variables were included in the analysis participant characteristics, clinical number of all teeth, and radiographic prevalence and characteristics of third molars. Statistics included chi-squared, Fisher's exact, and Kruskal-Wallis tests and SAS-SUDAAN calculations. RESULTS A total of 5912 third molars in 47.8% of the study population were recorded from panoramic radiographs. At least one impacted third molar was found in 21.9% of the study population. More than half (57.3%) of the remaining third molars were located in the mandible. A preponderance of participants with all third molars missing were observed in the oldest age group, women, those with lower education and those living in the countryside. Third molars or remnants thereof were observed radiographically in 3.9% of clinically edentulous study population. CONCLUSIONS The panoramic radiographs disclosed many remaining third molars in adult Finns aged ≥30 years. One-third of the third molars located impacted which may cause unexpected need for care. https://www.selleckchem.com/products/pf-04957325.html © 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.OBJECTIVES This study aimed to clarify the efficacy of a border-moulding procedure with low-flow silicone impression material compared with a conventional compound to complete denture fabrication. It also aimed to evaluate the influence of various functional tasks during the lingual-side moulding procedure regarding the depth and width of the border. METHODS Ten dentate subjects (three men, seven women; average age 30 years) were enrolled in this study after giving informed consent. A specially designed custom impression tray for the mandibular lingual side was fabricated for each subject. With the tray and heavy-body-type silicone material, lingual border moulding was performed that included four functional tasks tongue protrusion (TP), licking the upper lip with the tongue (UL), swallowing (SW), and placing the tongue tip to the palate (PP). RESULTS Within the limitations of this study, the results suggested that heavy-body silicone impression material is satisfactory for use in the border-moulding procedure, giving reproducible results. CONCLUSION There were no significant differences among the functional tasks regarding the depth and width of the lingual flange except for swallowing, which exhibited the largest values. © 2020 John Wiley & Sons Ltd.

11/10/2024


whereas the remaining products have limited data to support their safety.This study aimed at exploring the role of EgRad54 and the effect of harmine (HM) or HM derivatives (HMDs) on DNA damage in Echinococcus granulosus. DNA damage in E. granulosus protoscoleces (PSCs) was assessed by using a comet assay, after treatment with HM or HMDs. Efficiency of electroporation-based transfection of PSCs and subsequent EgRad54 knockdown was evaluated by using real-time quantitative polymerase chain reaction (RT-qPCR) and fluorescence intensity. Viability of PSCs was determined via eosin exclusion test, and expression of related genes was analyzed via RT-qPCR. HM and HMDs significantly (p  less then  0.05) increased DNA damage in E. granulosus, and upregulated EgRad54 expression. Compared with HM and HMD-only treatment groups, EgRad54 knockdown combined with HM and HMD treatment further reduced E. https://www.selleckchem.com/products/Gefitinib.html granulosus viability. This combined approach resulted in significant (p  less then  0.05) downregulation of Rad54 and Topo2a expression, and upregulation of ATM expression, whereas H2A and P53 expression was significantly higher compared with control groups. These data show that EgRad54 knockdown, combined with HM or HMD treatment, enhances DNA damage in E. granulosus via upregulation of ATM and H2A, and downregulation of Rad54 and Topo2a, thereby inhibiting E. granulosus growth, and suggest that EgRad54 is a potential therapeutic target for cystic echinococcosis treatment.
Individual risk prediction based on genome-wide polygenic risk scores (PRSs) using millions of genetic variants has attracted much attention. It is under debate whether PRS models can be applied-without loss of precision-to populations of similar ethnic but different geographic background than the one the scores were trained on. Here, we examine how PRS trained in population-specific but European data sets perform in other European subpopulations in distinguishing between coronary artery disease patients and healthy individuals.

We use data from UK and Estonian biobanks (UKB, EB) as well as case-control data from the German population (DE) to develop and evaluate PRS in the same and different populations.

PRSs have the highest performance in their corresponding population testing data sets, whereas their performance significantly drops if applied to testing data sets from different European populations. Models trained on DE data revealed area under the curves in independent testing sets in DE 0.6752, EB 0.6156, and UKB 0.5989; trained on EB and tested on EB 0.6565, DE 0.5407, and UKB 0.6043; trained on UKB and tested on UKB 0.6133, DE 0.5143, and EB 0.6049.

This result has a direct impact on the clinical usability of PRS for risk prediction models using PRS a population effect must be kept in mind when applying risk estimation models, which are based on additional genetic information even for individuals from different European populations of the same ethnicity.
This result has a direct impact on the clinical usability of PRS for risk prediction models using PRS a population effect must be kept in mind when applying risk estimation models, which are based on additional genetic information even for individuals from different European populations of the same ethnicity.Background Prehabilitation encompasses multidisciplinary interventions to improve health and lessen incidence of surgical deterioration by reducing physiologic stress and functional decline. This study presents an interim analysis to demonstrate prehabilitation for hepatopancreatobiliary (HPB) surgical patients.Methods In 2018, a structured prehabilitation pilot program was implemented. Eligibility required HPB malignancy, neoadjuvant chemotherapy, and residence within hour drive. Patients were enrolled into the 4-month program. The fitness component was composed of timed up and go test and grip strength with exercise recommendations. Nutrition involved evaluation of sarcopenic obesity, glucose management, and smoking and alcohol counseling. Psychological services included psychosocial assessments and advanced care planning, with social work referrals. Component were evaluated monthly by a physician using laboratory results, nutritional data and questionnaires, psychological assessments, and validated fitness tests. Nurse navigators spoke with patients weekly to monitor compliance.Results At 12 months, nineteen patients were enrolled. Ten completed prehabilitation, neoadjuvant chemotherapy and underwent their surgical procedure. There were no differences found after prehabilitation in functional status, physical performance, psychosocial assessments, or nutrition. Frailty, as assessed by Fried frailty criteria, improved significantly after prehabilitation (P less then .0001). Symptom severity and laboratory values did not change. Length of stay was 6.5 days and all patients were discharged to home. There was 1 readmission for transient ischemic attack and 90-day mortality rate was 0%.Discussion Prehabilitation to improve recovery is a promising concept encompassing a wide array of multidisciplinary assessments and interventions. It may demonstrate a protective effect on physiologic decline from chemotherapy and may reverse frailty phenotypes.
Preventable intraoperative errors have the potential to lead to adverse events. Our objective was to build a conceptual model of the relationship between minute technical errors performed by the surgeon and adverse patient outcomes.

We used constructivist grounded theory methodology to build a model for the avoidance of technical errors. We used the Observational Clinical Human Reliability Assessment system, which categorizes granular, technical intraoperative errors, as our conceptual framework. We iteratively interviewed surgeons from multiple adult and pediatric surgical specialties, refined our semi-structured interview, and developed a conceptual model. Our model remained stable after interviewing 11 surgeons, and we reviewed it with earlier interviewed surgeons.

Our conceptual model helps us understand how technical errors can be associated with adverse outcomes and is applicable to a broad range of surgical steps. Each technical error is defined by a unique improper technical motion that without a compensatory response, it may lead to 1 or more discreet adverse outcomes.

10/31/2024


Intravenous iron therapy is increasingly used in patients with iron deficiency anemia, although concerns of hypophosphatemia have been recently raised. https://www.selleckchem.com/products/gsk2879552-2hcl.html The aim of this study was to evaluate different intravenous iron formulations for the risk of hypophosphatemia. Medline, Scopus, Cochrane Central Register of Controlled Trials, Web of Science, Clinicaltrials.gov, and Google Scholar databases were systematically searched to 20 March 2020. All randomized controlled trials reporting the incidence of hypophosphatemia among adult patients treated with any intravenous iron preparation were included. Pool estimates were obtained by applying an arm-based Bayesian network meta-analysis model. Eight randomized controlled trials were included, comprising 5989 patients. Ferric carboxymaltose was associated with significantly higher incidence of hypophosphatemia compared to iron isomaltoside (risk ratio [RR] 7.90, 95% confidence interval [CI] 2.10-28.0), iron sucrose (RR 9.40, 95% CI 2.30-33.0), iron dextran (RR 6.60, 95% CI 1.91-220.0), and ferumoxytol (RR 24.0, 95% CI 2.50-220.0). Therefore, ferric carboxymaltose ranked as the worst treatment presenting the highest surface under the cumulative ranking curve (99.1%). No significant differences were estimated for the comparisons among iron isomaltoside, iron sucrose, iron dextran, and ferumoxytol. In conclusion, it is suggested that the occurrence of hypophosphatemia is common after the administration of intravenous ferric carboxymaltose. Further research is needed in large-scale randomized controlled trials to determine the risk of symptomatic and persistent hypophosphatemia as well as to elucidate the exact pathophysiology of the observed association.
The Standardized Uptake Value (SUV) in single lesions on
F-FDG PET/CT scans and serum S-100B concentrations are inversely associated with disease-free survival in stage IV melanoma. The aim of this study was to assess the association between biomarkers (S-100B, LDH) and the PET-derived metrics SUV
, metabolic active tumor volume (MATV), and total lesion glycolysis (TLG) in stage IV melanoma in order to understand what these biomarkers reflect and their possible utility for follow-up.

In 52 stage IV patients the association between PET-derived metrics and the biomarkers S-100B and LDH was assessed and the impact on survival analyzed.

S-100B was elevated (>0.15μg/l) in 37 patients (71%), LDH in 11 (21%). There was a correlation between S-100B and LDH (R
=0.19). S-100B was correlated to both MATV (R
=0.375) and TLG (R
=0.352), but LDH was not. Higher MATV and TLG levels were found in patients with elevated S-100B (p<0.001) and also in patients with elevated LDH (>250 U/l) (p<0.001). There was no association between the biomarkers and SUV
. Survival analysis indicated that LDH was the only predictor of melanoma-specific survival.

In newly diagnosed stage IV melanoma patients S-100B correlates with
F-FDG PET/CT derived MATV and TLG in contrast to LDH, is more often elevated than LDH (71% vs. 21%) and seems to be a better predictor of disease load and disease progression. However, elevated LDH is the only predictor for survival. The biomarkers, S-100B and LDH appear to describe different aspects of the extent of metastatic disease and of tumornecrosis.
In newly diagnosed stage IV melanoma patients S-100B correlates with 18F-FDG PET/CT derived MATV and TLG in contrast to LDH, is more often elevated than LDH (71% vs. 21%) and seems to be a better predictor of disease load and disease progression. However, elevated LDH is the only predictor for survival. The biomarkers, S-100B and LDH appear to describe different aspects of the extent of metastatic disease and of tumornecrosis.New methods of working in relation to the management of patients requiring palliative radiotherapy are being embraced in hospital departments around the world. Team members are expanding on their previously assigned scope of practice to take on duties that had previously only been assigned to a consultant clinical oncologist. Career frameworks such as the four-tier model have been built upon to identify the skills held by other healthcare professionals and show how they may be best placed to take on additional roles within a patient pathway. Experiences of four departments in different countries report their local experiences in using both therapeutic radiographers and nursing staff to undertake advanced and consultant-level practice in relation to the management of both palliative radiotherapy patients and their research work streams. Involvement of other healthcare professionals within the clinical or research pathway for the management of palliative radiotherapy patients can be achieved. Their involvement can support clinicians and help to ensure the safe and efficient management of patients requiring palliative radiotherapy.
This paper uses the Taxonomy of Everyday Self-management Strategies (TEDSS) to provide insight and understanding into the complex and interdependent self-management strategies people with neurological conditions use to manage everyday life.

As part of a national Canadian study, structured telephone interviews were conducted monthly for eleven months, with 117 people living with one or more neurological conditions. Answers to five open-ended questions were analyzed using qualitative content analysis. A total of 7236 statements were analyzed.

Findings are presented in two overarching patterns 1) self-management pervades all aspects of life, and 2) self-management is a chain of decisions and behaviours. Participants emphasized management of daily activities and social relationships as important to maintaining meaning in their lives.

Managing everyday life with a neurological condition includes a wide range of diverse strategies that often interact and complement each other. Some people need to intentionally manage every aspect of everyday life.

For people living with neurological conditions, there is a need for health providers and systems to go beyond standard advice for self-management. Self-management support is best tailored to each individual, their life context and the realities of their illness trajectory.
For people living with neurological conditions, there is a need for health providers and systems to go beyond standard advice for self-management. Self-management support is best tailored to each individual, their life context and the realities of their illness trajectory.

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11/13/2024


© 2020 Blackwell Verlag GmbH.Agricultural expansion encroaches on tropical forests and primates in such landscapes frequently incorporate crops into their diet. Understanding the nutritional drivers behind crop-foraging can help inform conservation efforts to improve human-primate coexistence. This study builds on existing knowledge of primate diets in anthropogenic landscapes by estimating the macronutrient content of 24 wild and 11 cultivated foods (90.5% of food intake) consumed by chimpanzees (Pan troglodytes verus) at Bossou, Guinea, West Africa. We also compared the macronutrient composition of Bossou crops to published macronutrient measures of crops from Bulindi, Uganda, East Africa. The composition of wild fruits, leaves, and pith were consistent with previous reports for primate diets. Cultivated fruits were higher in carbohydrates and lower in insoluble fiber than wild fruits, while wild fruits were higher in protein. Macronutrient content of cultivated pith fell within the ranges of consumed wild pith. Oil palm food parts were relatively rich in carbohydrates, protein, lipids, and/or fermentable fiber, adding support for the nutritional importance of the oil palm for West African chimpanzees. We found no differences in the composition of cultivated fruits between Bossou and Bulindi, suggesting that macronutrient content alone does not explain differences in crop selection. Our results build on the current understanding of chimpanzee feeding ecology within forest-agricultural mosaics and provide additional support for the assumption that crops offer primates energetic benefits over wild foods. © 2020 Wiley Periodicals, Inc.PURPOSE In 2004, Boumezbeur et al proposed a simple yet powerful approach to detect the metabolism of 13 C-enriched substrates in the brain. Their approach consisted of dynamic 1 H-MRS, without a 13 C radiofrequency (RF) channel, and its successful application was demonstrated in monkeys. Since then, this promising method has yet to be applied rigorously in humans. In this study, we revisit the use of dynamic 1 H-MRS to measure the metabolism of 13 C-enriched substrates and demonstrate its application in the human brain. METHODS In healthy participants, 1 H-MRS data were acquired dynamically before and following a bolus infusion of [1-13 C] glucose. Data were acquired on a 3T clinical MRI scanner using a short-TE SPECIAL sequence, with regions of interest in both anterior and posterior cingulate cortex. Using simulated basis spectra to model signal changes in both 12 C-bonded and 13 C-coupled resonances, the acquired spectra were fit in LCModel to obtain labeling time courses for glutmate and glutamine at both C4 and C3 positions. RESULTS Presence of the 13 C label was clearly detectable, owing to the pronounced effect of heteronuclear (13 C-1 H) scalar coupling on the observed 1 H spectra. A decrease in signal from 12 C-bonded protons and an increase in signal from 13 C-coupled protons were observed. The fractional enrichment of Glu-C4, (Glu+Gln)-C4, and (Glu+Gln)-C3 at 30 minutes following infusion of [1-13 C] glucose was similar in both regions 11% to 13%, 9% to 12% and 3% to 5%, respectively. CONCLUSION These preliminary results confirm the feasibility of the use of dynamic 1 H-MRS to monitor 13 C labeling in the human brain, without a 13 C RF channel. © 2020 International Society for Magnetic Resonance in Medicine.OBJECTIVES The aim of the study was to examine the prevalence of third molars in panoramic radiographs in a population-based study of adults aged ≥30 years. METHODS Out of a sample of 8028 inhabitants of Finland, selected with two-staged stratified cluster-sampling method for the Health 2000 Survey, 5989 participated in clinical oral examination and panoramic radiography. Mean age was 52.5 years (SD 14.6; range 30-97 years). The following variables were included in the analysis participant characteristics, clinical number of all teeth, and radiographic prevalence and characteristics of third molars. Statistics included chi-squared, Fisher's exact, and Kruskal-Wallis tests and SAS-SUDAAN calculations. RESULTS A total of 5912 third molars in 47.8% of the study population were recorded from panoramic radiographs. At least one impacted third molar was found in 21.9% of the study population. More than half (57.3%) of the remaining third molars were located in the mandible. A preponderance of participants with all third molars missing were observed in the oldest age group, women, those with lower education and those living in the countryside. Third molars or remnants thereof were observed radiographically in 3.9% of clinically edentulous study population. CONCLUSIONS The panoramic radiographs disclosed many remaining third molars in adult Finns aged ≥30 years. One-third of the third molars located impacted which may cause unexpected need for care. https://www.selleckchem.com/products/pf-04957325.html © 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.OBJECTIVES This study aimed to clarify the efficacy of a border-moulding procedure with low-flow silicone impression material compared with a conventional compound to complete denture fabrication. It also aimed to evaluate the influence of various functional tasks during the lingual-side moulding procedure regarding the depth and width of the border. METHODS Ten dentate subjects (three men, seven women; average age 30 years) were enrolled in this study after giving informed consent. A specially designed custom impression tray for the mandibular lingual side was fabricated for each subject. With the tray and heavy-body-type silicone material, lingual border moulding was performed that included four functional tasks tongue protrusion (TP), licking the upper lip with the tongue (UL), swallowing (SW), and placing the tongue tip to the palate (PP). RESULTS Within the limitations of this study, the results suggested that heavy-body silicone impression material is satisfactory for use in the border-moulding procedure, giving reproducible results. CONCLUSION There were no significant differences among the functional tasks regarding the depth and width of the lingual flange except for swallowing, which exhibited the largest values. © 2020 John Wiley & Sons Ltd.

11/10/2024


whereas the remaining products have limited data to support their safety.This study aimed at exploring the role of EgRad54 and the effect of harmine (HM) or HM derivatives (HMDs) on DNA damage in Echinococcus granulosus. DNA damage in E. granulosus protoscoleces (PSCs) was assessed by using a comet assay, after treatment with HM or HMDs. Efficiency of electroporation-based transfection of PSCs and subsequent EgRad54 knockdown was evaluated by using real-time quantitative polymerase chain reaction (RT-qPCR) and fluorescence intensity. Viability of PSCs was determined via eosin exclusion test, and expression of related genes was analyzed via RT-qPCR. HM and HMDs significantly (p  less then  0.05) increased DNA damage in E. granulosus, and upregulated EgRad54 expression. Compared with HM and HMD-only treatment groups, EgRad54 knockdown combined with HM and HMD treatment further reduced E. https://www.selleckchem.com/products/Gefitinib.html granulosus viability. This combined approach resulted in significant (p  less then  0.05) downregulation of Rad54 and Topo2a expression, and upregulation of ATM expression, whereas H2A and P53 expression was significantly higher compared with control groups. These data show that EgRad54 knockdown, combined with HM or HMD treatment, enhances DNA damage in E. granulosus via upregulation of ATM and H2A, and downregulation of Rad54 and Topo2a, thereby inhibiting E. granulosus growth, and suggest that EgRad54 is a potential therapeutic target for cystic echinococcosis treatment.
Individual risk prediction based on genome-wide polygenic risk scores (PRSs) using millions of genetic variants has attracted much attention. It is under debate whether PRS models can be applied-without loss of precision-to populations of similar ethnic but different geographic background than the one the scores were trained on. Here, we examine how PRS trained in population-specific but European data sets perform in other European subpopulations in distinguishing between coronary artery disease patients and healthy individuals.

We use data from UK and Estonian biobanks (UKB, EB) as well as case-control data from the German population (DE) to develop and evaluate PRS in the same and different populations.

PRSs have the highest performance in their corresponding population testing data sets, whereas their performance significantly drops if applied to testing data sets from different European populations. Models trained on DE data revealed area under the curves in independent testing sets in DE 0.6752, EB 0.6156, and UKB 0.5989; trained on EB and tested on EB 0.6565, DE 0.5407, and UKB 0.6043; trained on UKB and tested on UKB 0.6133, DE 0.5143, and EB 0.6049.

This result has a direct impact on the clinical usability of PRS for risk prediction models using PRS a population effect must be kept in mind when applying risk estimation models, which are based on additional genetic information even for individuals from different European populations of the same ethnicity.
This result has a direct impact on the clinical usability of PRS for risk prediction models using PRS a population effect must be kept in mind when applying risk estimation models, which are based on additional genetic information even for individuals from different European populations of the same ethnicity.Background Prehabilitation encompasses multidisciplinary interventions to improve health and lessen incidence of surgical deterioration by reducing physiologic stress and functional decline. This study presents an interim analysis to demonstrate prehabilitation for hepatopancreatobiliary (HPB) surgical patients.Methods In 2018, a structured prehabilitation pilot program was implemented. Eligibility required HPB malignancy, neoadjuvant chemotherapy, and residence within hour drive. Patients were enrolled into the 4-month program. The fitness component was composed of timed up and go test and grip strength with exercise recommendations. Nutrition involved evaluation of sarcopenic obesity, glucose management, and smoking and alcohol counseling. Psychological services included psychosocial assessments and advanced care planning, with social work referrals. Component were evaluated monthly by a physician using laboratory results, nutritional data and questionnaires, psychological assessments, and validated fitness tests. Nurse navigators spoke with patients weekly to monitor compliance.Results At 12 months, nineteen patients were enrolled. Ten completed prehabilitation, neoadjuvant chemotherapy and underwent their surgical procedure. There were no differences found after prehabilitation in functional status, physical performance, psychosocial assessments, or nutrition. Frailty, as assessed by Fried frailty criteria, improved significantly after prehabilitation (P less then .0001). Symptom severity and laboratory values did not change. Length of stay was 6.5 days and all patients were discharged to home. There was 1 readmission for transient ischemic attack and 90-day mortality rate was 0%.Discussion Prehabilitation to improve recovery is a promising concept encompassing a wide array of multidisciplinary assessments and interventions. It may demonstrate a protective effect on physiologic decline from chemotherapy and may reverse frailty phenotypes.
Preventable intraoperative errors have the potential to lead to adverse events. Our objective was to build a conceptual model of the relationship between minute technical errors performed by the surgeon and adverse patient outcomes.

We used constructivist grounded theory methodology to build a model for the avoidance of technical errors. We used the Observational Clinical Human Reliability Assessment system, which categorizes granular, technical intraoperative errors, as our conceptual framework. We iteratively interviewed surgeons from multiple adult and pediatric surgical specialties, refined our semi-structured interview, and developed a conceptual model. Our model remained stable after interviewing 11 surgeons, and we reviewed it with earlier interviewed surgeons.

Our conceptual model helps us understand how technical errors can be associated with adverse outcomes and is applicable to a broad range of surgical steps. Each technical error is defined by a unique improper technical motion that without a compensatory response, it may lead to 1 or more discreet adverse outcomes.

10/31/2024


Intravenous iron therapy is increasingly used in patients with iron deficiency anemia, although concerns of hypophosphatemia have been recently raised. https://www.selleckchem.com/products/gsk2879552-2hcl.html The aim of this study was to evaluate different intravenous iron formulations for the risk of hypophosphatemia. Medline, Scopus, Cochrane Central Register of Controlled Trials, Web of Science, Clinicaltrials.gov, and Google Scholar databases were systematically searched to 20 March 2020. All randomized controlled trials reporting the incidence of hypophosphatemia among adult patients treated with any intravenous iron preparation were included. Pool estimates were obtained by applying an arm-based Bayesian network meta-analysis model. Eight randomized controlled trials were included, comprising 5989 patients. Ferric carboxymaltose was associated with significantly higher incidence of hypophosphatemia compared to iron isomaltoside (risk ratio [RR] 7.90, 95% confidence interval [CI] 2.10-28.0), iron sucrose (RR 9.40, 95% CI 2.30-33.0), iron dextran (RR 6.60, 95% CI 1.91-220.0), and ferumoxytol (RR 24.0, 95% CI 2.50-220.0). Therefore, ferric carboxymaltose ranked as the worst treatment presenting the highest surface under the cumulative ranking curve (99.1%). No significant differences were estimated for the comparisons among iron isomaltoside, iron sucrose, iron dextran, and ferumoxytol. In conclusion, it is suggested that the occurrence of hypophosphatemia is common after the administration of intravenous ferric carboxymaltose. Further research is needed in large-scale randomized controlled trials to determine the risk of symptomatic and persistent hypophosphatemia as well as to elucidate the exact pathophysiology of the observed association.
The Standardized Uptake Value (SUV) in single lesions on
F-FDG PET/CT scans and serum S-100B concentrations are inversely associated with disease-free survival in stage IV melanoma. The aim of this study was to assess the association between biomarkers (S-100B, LDH) and the PET-derived metrics SUV
, metabolic active tumor volume (MATV), and total lesion glycolysis (TLG) in stage IV melanoma in order to understand what these biomarkers reflect and their possible utility for follow-up.

In 52 stage IV patients the association between PET-derived metrics and the biomarkers S-100B and LDH was assessed and the impact on survival analyzed.

S-100B was elevated (>0.15μg/l) in 37 patients (71%), LDH in 11 (21%). There was a correlation between S-100B and LDH (R
=0.19). S-100B was correlated to both MATV (R
=0.375) and TLG (R
=0.352), but LDH was not. Higher MATV and TLG levels were found in patients with elevated S-100B (p<0.001) and also in patients with elevated LDH (>250 U/l) (p<0.001). There was no association between the biomarkers and SUV
. Survival analysis indicated that LDH was the only predictor of melanoma-specific survival.

In newly diagnosed stage IV melanoma patients S-100B correlates with
F-FDG PET/CT derived MATV and TLG in contrast to LDH, is more often elevated than LDH (71% vs. 21%) and seems to be a better predictor of disease load and disease progression. However, elevated LDH is the only predictor for survival. The biomarkers, S-100B and LDH appear to describe different aspects of the extent of metastatic disease and of tumornecrosis.
In newly diagnosed stage IV melanoma patients S-100B correlates with 18F-FDG PET/CT derived MATV and TLG in contrast to LDH, is more often elevated than LDH (71% vs. 21%) and seems to be a better predictor of disease load and disease progression. However, elevated LDH is the only predictor for survival. The biomarkers, S-100B and LDH appear to describe different aspects of the extent of metastatic disease and of tumornecrosis.New methods of working in relation to the management of patients requiring palliative radiotherapy are being embraced in hospital departments around the world. Team members are expanding on their previously assigned scope of practice to take on duties that had previously only been assigned to a consultant clinical oncologist. Career frameworks such as the four-tier model have been built upon to identify the skills held by other healthcare professionals and show how they may be best placed to take on additional roles within a patient pathway. Experiences of four departments in different countries report their local experiences in using both therapeutic radiographers and nursing staff to undertake advanced and consultant-level practice in relation to the management of both palliative radiotherapy patients and their research work streams. Involvement of other healthcare professionals within the clinical or research pathway for the management of palliative radiotherapy patients can be achieved. Their involvement can support clinicians and help to ensure the safe and efficient management of patients requiring palliative radiotherapy.
This paper uses the Taxonomy of Everyday Self-management Strategies (TEDSS) to provide insight and understanding into the complex and interdependent self-management strategies people with neurological conditions use to manage everyday life.

As part of a national Canadian study, structured telephone interviews were conducted monthly for eleven months, with 117 people living with one or more neurological conditions. Answers to five open-ended questions were analyzed using qualitative content analysis. A total of 7236 statements were analyzed.

Findings are presented in two overarching patterns 1) self-management pervades all aspects of life, and 2) self-management is a chain of decisions and behaviours. Participants emphasized management of daily activities and social relationships as important to maintaining meaning in their lives.

Managing everyday life with a neurological condition includes a wide range of diverse strategies that often interact and complement each other. Some people need to intentionally manage every aspect of everyday life.

For people living with neurological conditions, there is a need for health providers and systems to go beyond standard advice for self-management. Self-management support is best tailored to each individual, their life context and the realities of their illness trajectory.
For people living with neurological conditions, there is a need for health providers and systems to go beyond standard advice for self-management. Self-management support is best tailored to each individual, their life context and the realities of their illness trajectory.

10/21/2024


The growth of Pseudomonas aeruginosa and Staphylococcus aureus were effectively inhibited by all the solvent extracted fractions from the fruits while aqueous fraction was not able to inhibit the growth of Bacillus subtilis. The growth of Candida albicans was effectively inhibited by ethyl acetate extracted fraction from leaves at 3 mg disc-1 concentration.TGF-β signal pathway activation is vital in the pathogenesis of DKD. We aim to investigate the role of Yishenhuoxue formula on TGF-β/Smad signal transduction in DKD rats. 60 male adult Wistar rats were enrolled and randomly allocated into four groups N group, M group (given STZ 60mg/kg, ip), H group (given Yishenhuoxue formula 1.0g/kg/day, ig) and L group (given Yishenhuoxue formula 0.5g/kg/day, ig). The levels of BW, 24h UV, SCr, UCr, mALB were measured after 8 weeks treatment, while the levels of KW/BW index, CCr and UAER were calculated by relevant formula. The rats' left kidneys were harvested to detect histological changes by PAS staining and right kidneys were harvested to detect the levels of TGF-β, Smad2/3, phosphorylated Smad 2/3, Smad 7 and CTGF by western blot analysis. We found that Yishenhuoxue formula treatment can protect kidneys from DKD injury, which is illustrated with following criteria 1) a significant decrement in KW/BW index, 24h UV, SCr, mALB and UAER, while a significant increment in BW, UCr, CCr (p less then 0.05 vs. M group); 2) minor and segmental changes as slight expansion of the glomerular basement membrane compared with M group; 3) an apparent decrease in levels of TGF-β1, phosphorylated Smad 2/3 and CTGF, while an apparent increase in levels of Smad 2/3 and Smad7 compared with M group (p less then 0.05). The studies confirm that Yishenhuoxue formula has strong inhibitory effect on TGF-β/Smad signal transduction in DKD rats' kidneys by decreasing expression of TGF-β1, weakening of Smad 2/3 phosphorylation and increasing expression of Smad 7.Three substituted flavone derivatives have been synthesized from substituted O-hydroxy acetophenones and 4-trifluoromethyl benzaldehyde in good yield. These compounds were characterized by NMR spectroscopy and single crystal X-ray Diffraction. Compound F1 and F3 were re-crystallized from their concentrated solutions in chloroform ethyl acetate mixture while F2 was re-crystallized in ethyl acetate n-hexane mixture. Compound F1 and F3 are monoclinic (space group P21/c) with lattice parameters [a, b, c (A) / β (°)] = 13.332 (2), 15.616 (2) / 6.2898 (8) and 13.9716 (15), 7.1868 (7), 13.6912 (14) / 91.113(6) respectively. Compound F2 is Triclinic (space group P-1) and has lattice parameters [a, b, c (Å) / α, β, γ (°)] = 6.5002 (6), 8.3801 (9), 13.5989 (14) / 89.348(5), 85.141(4), 84.521(5). Antioxidant, antibacterial and cytotoxic profile was investigated. https://www.selleckchem.com/products/bi-2493.html The compounds showed moderate to less activity on 1,1-diphenyl-2-picryl-hydrazyl (DPPH), Hydrogen peroxide (H/2/O/2) and 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulphonic acid) (ABTS) models of radical scavenging activity while promising antibacterial potentials were recorded. Furthermore, these molecules can also be used as potential candidates for new antitumor agents.This is a new expanded method of determining the characterisation of fucoidan from Laminaria japonica (kelp) in rat plasma by high-performance liquid chromatography (HPLC) with fluorescence detection. We tagged fucoidan by fluoresce in isothiocyanate (FITC) for tracking and treated the plasma samples via protein precipitation with 10% trichloroacetic acid and methanol. Column chromatography separation was on a TSK-G4000sw column (7.8 mm × 300 mm, 5 mm) by elution with 0.15 M NaCl. The quantification of fucoidan was performed by HPLC with fluorescence detection. The results suggested that the calibration curve for fucoidan concentration was linear dependent in the limits of 0.5-100μg/mL. The lower limit of quantitation (LLOQ) was 0.5μg/mL and the lower limit of detection (LLOD) was 0.15μg/mL. The intra-day and inter-day precision values were less than 13%and the accuracy ranged from 96.83 to 100.03% at 3 different concentrations. The fucoidan stability of rat plasma at different temperatures and time-points was estimated. The extraction efficiencies ranged from 93.33 to 96.53%and the matrix effect ranged from 92.67 to 95.83%. Method selectivity was evaluated as well. We successfully studied the pharmacokinetic of fucoidan in rat plasma after oral by the validated method. Fucoidan was administered to rats intravenously at a dose of 6 mg/kg and orally at a dose of 20 mg/kg. The Cmax was 7.33μg/mL within 2 h by oral administration; The initial Cmax was 75.59μg/mL. The bioavailability of fucoidan after oral administration to rats was 8.91%.AIMS This study evaluated associations between coronary collaterals and myocardial viability assessed by quantitative cardiac magnetic resonance (CMR) imaging in patients with a chronic coronary total occlusion (CTO). METHODS AND RESULTS 218 patients with a CTO who underwent CMR between 2013-2018 were included. A concomitant collateral connection (CC) score 2 and Rentrop grade 3 defined well-developed collaterals in 146 (67%) patients, whereas lower CC scores or Rentrop grades characterized poorly-developed collaterals. Dysfunctional myocardium (50%) was observed in only 5% of CTO segments. In the CTO territory, SWT was higher (3.72±1.51 vs. 3.05±1.60mm, p less then 0.01) and extent of scar was lower (7.0 [0.1-16.7] vs. 13.1% [2.8-22.2], p=0.048) in patients having well-developed vs. poorly-developed collaterals. Viability was more prevalent in CTO segments among patients with poorly-developed vs. well-developed collaterals (44% vs. 30% of segments, p less then 0.01), predominantly due to higher prevalence of dysfunctional myocardium (51% vs. 34% of segments, p less then 0.01) in the poorly-developed collateral group. CONCLUSIONS The infarcted area in myocardium subtended by a CTO is generally limited. Well-developed collaterals are associated with less myocardial scar and enhanced preserved function. However, viability was regularly present in patients with poorly-developed collaterals.

10/12/2024


Mechanical, thermal, and biological (composting) pretreatments generate mild improvement at laboratory-scale and are proved applicable in full-scale facilities. It is noteworthy that the introduction of additives (Fe-based nanomaterials, carbon-based materials, and composites) is acquiring more attention and shows promising full-scale application potential. Finally, bio-electrochemical fields stand out in laboratory trials and may serve as future reactor modules in agricultural anaerobic digestion installations treating cow manure.The rising temperature makes the weather becoming more extreme. Understanding how extreme hot temperature-heat wave events (HWEs)-are likely to alter individual heat exposure and sensitivity is crucial for developing climate change mitigation and adaptation strategies. Despite the importance, little is known about the real-time impacts of HWEs on individual daily life in developing nations, like China. To fill this gap, we adopt over 1544 thousand Weibo (Chinese Twitter) social media data, coupled with meteorological conditions people face when posting, to assess the heat exposure and people's sensitivity to HWEs across 31 mega-cities in China. The results show the hotspot of Weibo heat is coincident with the extremely hot temperature, with a correlation of 0.7 (p less then 0.05). The intensities, frequencies, and durations of HWEs in both geographical and social media space have high spatial heterogeneity. Its spatial variation can be explained by the type of climate zone and the unique geographical environment. The cities with extreme hot weather are more likely to adapt to the heatwave and less sensitivity to HWEs. The proposed framework, which integrates the real-time social media semantic analysis, statistical method, and spatial techniques, provides a new paradigm to assess the HWEs exposure and sensitivity analysis in China.We explore the interplay between preventative risk management and regulatory style for the implementation of water safety plans in Malaysia and in England and Wales, two jurisdictions with distinct philosophies of approach. Semi-structured interviews were conducted with 32 water safety professionals in Malaysia, 23 in England and Wales, supported by 6 Focus Group Discussions (n = 53 participants). A grounded theory approach produced insights on the transition from drinking water quality surveillance to preventative risk management. Themes familiar to this type of regulatory transition emerged, including concerns about compliance policy; overseeing the risk management controls of regulatees with varied competencies and funds available to drive change; and the portfolio of interventions suited to a more facilitative regulatory style. Because the potential harm from waterborne illness is high where pathogen exposures occur, the transition to risk-informed regulation demands mature organisational cultures among water utilities and regulators, and a laser-like focus on ensuring risk management controls are delivered within water supply systems.Invasive plants have long been recognized for altering ecosystem properties, but their long-term impacts on ecosystem processes remain largely unknown. In this study, we determined the impact of Egeria densa Planch, a globally invasive freshwater macrophyte, on sedimentation processes in a large tidal freshwater region. We measured carbon accumulation (CARs) and inorganic sedimentation rates in submerged aquatic vegetation SAV dominated by E. densa and compared these rates to those of adjacent tidal freshwater marshes. Study sites were chosen along a range of hydrodynamic conditions in the Sacramento-San Joaquin Delta of California, USA, where E. densa has been widespread since 1990. https://www.selleckchem.com/products/nec-1s-7-cl-o-nec1.html Cores were analyzed for bulk density, % inorganic matter, % organic carbon, 210Pb, and 137Cs. Our results show that E. densa patches constitute sinks for both "blue carbon" and inorganic sediment. Compared to marshes, E. densa patches have greater inorganic sedimentation rates (E. densa 1103-5989 g m-2 yr-1, marsh 393-1001 g m-2 yr-1, p  0.05). Sediment stored by E. densa likely reduces the resilience of adjacent marshes by depleting the sediment available for marsh-building. Because of its harmful traits, E. densa is not a suitable candidate for mitigating carbon pollution; however, currently invaded habitats may already contain a meaningful component of regional carbon budgets. Our results strongly suggest that E. densa patches are sinks for carbon and inorganic sediment throughout its global range, raising questions about how invasive SAV is altering biogeochemical cycling and sediment dynamics across freshwater ecosystems.The European Alps are known as the 'water towers of Europe'. However, climatic and socioeconomic changes influence both water supply and demand, increasing the need to manage this limited and valuable resource properly to avoid user conflicts and water scarcity. Two major challenges emerge when assessing water scarcity in the Alps Firstly, mountainous regions are very heterogeneous regarding water availability and demand over space and time, and therefore water scarcity assessments need to be done at low temporal and spatial scales. Secondly, the tight coupling of the natural and the social sphere necessitate an integrative approach considering dynamics and interactions of the social-ecological system. Hence, we applied the agent-based water supply and demand model Aqua.MORE, which is designed for catchment scale and sub-daily temporal resolution, to a case study site in the Italian Alps. In the model, the water supply, the local water managers and water users are represented by interacting model agents. We estimated the water supply by refining the annual runoff data provided by the InVEST water yield model for within-year variations. Local stakeholders contributed to the development of quantitative and spatially-explicit scenarios for land use and tourism evolution. To evaluate water supply and demand dynamics, we assessed six scenarios for the period of 2015 to 2050 three different socio-economic policy pathways, both alone and in combination with a climate change scenario. In all six scenarios, the water demandsupply (DS) ratio continuously rises from 2015 to 2050.The highest DS ratio values are prognosed at the beginning of the irrigation period in May. In all scenarios considering climatic changes, the DS ratio exceeds 20% for several days, indicating potential water scarcity. The simulation results reinforce the importance of analysing water balances at a high temporal resolution and can support management processes and stakeholder dialogues for sustainable watershed management.Groundwater discharge zones in streams are important habitats for aquatic organisms. The use of discharge zones for thermal refuge and spawning by fish and other biota renders them susceptible to potential focused discharge of groundwater contamination. Currently, there is a paucity of information about discharge zones as a potential exposure pathway of chemicals to stream ecosystems. Using thermal mapping technologies to locate groundwater discharges, shallow groundwater and surface water from three rivers in the Chesapeake Bay Watershed, USA were analyzed for phytoestrogens, pesticides and their degradates, steroid hormones, sterols and bisphenol A. A Bayesian censored regression model was used to compare groundwater and surface water chemical concentrations. The most frequently detected chemicals in both ground and surface water were the phytoestrogens genistein (79%) and formononetin (55%), the herbicides metolachlor (50%) and atrazine (74%), and the sterol cholesterol (88%). There was evidence suggesting groundwater discharge zones could be a unique exposure pathway of chemicals to surface water systems, in our case, metolachlor sulfonic acid (posterior mean concentration = 150 ng/L in groundwater and 4.6 ng/L in surface water). Our study also demonstrated heterogeneity of chemical concentration in groundwater discharge zones within a stream for the phytoestrogen formononetin, the herbicides metolachlor and atrazine, and cholesterol. Results support the hypothesis that discharge zones are an important source of exposure of phytoestrogens and herbicides to aquatic organisms. To manage critical resources within the Chesapeake Bay Watershed, more work is needed to characterize exposure in discharge zones more broadly across time and space.The ecological efficacy of river restoration projects may change over time, resulting in the loss of their ecological function for targeted species. The goal of this study was to evaluate the rheophilic nursery function of restored floodplain channels over time, by analysing 30 years of monitoring data from 12 restoration projects in the lower river Rhine. We hypothesised that the nursery function would change over time, caused by the combined effects of decreasing flow conditions and succession processes affecting habitat heterogeneity. We found that nursery area suitability for rheophilic fish was almost 4 times higher in two-sided connected channels than in one-sided connected channels, although the response trends of rheophilic fish were similar for both water body types. These response curves showed clear optima with channel age, for rheophilic fish abundance at 13 to 14 years post-restoration, indicating optimal nursery conditions. On the other hand, rheophilic species richness showed a steadily decreasing trend with channel age, suggesting aging channels became less suitable as nursery areas for most rheophilic fish species. The presence of permanent flow was found to be the main driving factor in explaining both rheophilic fish community trends and habitat succession in individual restored channels. We did not observe an effect of habitat heterogeneity on nursery function for rheophilic fish. To create and maintain optimal nursery conditions in restored floodplain channels of strongly anthropogenically influenced rivers such as the river Rhine, we propose a management strategy involving cyclic rejuvenation through human intervention, focusing on restoring permanent flow, with a frequency of on average every 15 years, depending on the rate of aggradation and targeted rheophilic species. We also propose a thorough investigation of the relationship between habitat heterogeneity and nursery success in floodplain channels, as a next step in the identification of suitable nursery areas for rheophilic fishes.Rewilding has been proposed as an opportunity for biodiversity conservation in abandoned landscapes. However, rewilding is challenged by the increasing fire risk associated with more flammable landscapes, and the loss of open-habitat specialist species. Contrastingly, supporting High Nature Value farmlands (HNVf) has been also highlighted as a valuable option, but the effective implementation of agricultural policies often fails leading to uncertain scenarios wherein the effects of wildfire management remain largely unexplored. Herein, we simulated fire-landscape dynamics to evaluate how fire suppression scenarios affect fire regime and biodiversity (102 species of vertebrates) under rewilding and HNVf policies in the future (2050), in a transnational biosphere reserve (Gerês-Xurés Mountains, Portugal-Spain). Rewilding and HNVf scenarios were modulated by three different levels of fire suppression effectiveness. Then, we quantified scenario effects on fire regime (burned and suppressed areas) and biodiversity (habitat suitability change for 2050).