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PURPOSE: Surgical repair of complex abdominal wall hernias remains technically demanding and is widely recognized as a risk factor for unfavorable outcomes with high recurrence and morbidity rates. The objective is to assess short- and long-term complications after open intraperitoneal onlay mesh (IPOM) repair combined with bilateral anterior component separation (ACS) for large and difficult incisional hernias, alongside evaluating hernia recurrence rates. METHODS: This retrospective analysis utilized data sourced from Hospital electronic health records and a prospective database at an academic tertiary referral center. Data collection was carried out from patients operated between January 2006 and December 2017. Eligible patients had complex incisional hernias measuring at least 10 cm in their transverse diameter and had an open IPOM repair with bilateral ACS. RESULTS: In our study group of 45 patients, the 30-day surgical site occurrence (SSO) rate was high (37.8%), primarily consisting of superficial postoperative complications as seroma (17.8%) and wound dehiscence (6.7%). Among six patients (13.3%), wound complications escalated to chronic infected mesh-related problems, leading to complete mesh removal in four cases (8.9%) and partial mesh removal in two cases (4.4%). Regarding long-term complications, five patients (11.1%) developed enterocutaneous fistula. The recurrence rate was modest [5 out of 41 (12.2%)] over a median follow-up period of 99 months. CONCLUSIONS: Despite a high SSO rate, application of the open IPOM technique with ACS could serve as a valuable rescue option for managing large and complex hernias, with acceptable hernia recurrence rates at long-term follow-up.
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Hérnia Ventral , Herniorrafia , Hérnia Incisional , Recidiva , Telas Cirúrgicas , Humanos , Masculino , Feminino , Estudos Retrospectivos , Pessoa de Meia-Idade , Herniorrafia/métodos , Herniorrafia/efeitos adversos , Idoso , Hérnia Incisional/cirurgia , Hérnia Ventral/cirurgia , Complicações Pós-Operatórias/etiologia , Seroma/etiologia , Adulto , Deiscência da Ferida Operatória/etiologia , Idoso de 80 Anos ou maisRESUMO
Despite being the busiest transient sea in the world due to the Suez Canal, radionuclide distribution studies in seawater and sediment of the Red Sea remain rare. A sampling expedition in the Red Sea was conducted from June 9 to July 6, 2021, visiting a transect of several deep sampling stations located along the central axis of the basin from the Gulf of Aqaba to the southern Red Sea (near Farasan Island, Saudi Arabia). The collected seawater profile samples were analyzed for tritium, radiocarbon and oxygen-18. The observed tritium levels in surface waters of the Red Sea peaked at 0.3-0.4 TU, similar to the values observed in the western Arabian Sea (decay corrected). The values observed at waters below 150 m were around 0.2 TU, however, at depths of 450 and 750 m, tritium minima (<0.2 TU) were observed, which could be associated with a partial return flow of bottom waters from the southern to the northern Red Sea. At two stations at the depth of about 550 m, deep Δ14C minima were observed as well (-4 and -10), documenting ongoing transport of carbon in the water column, important for sink of anthropogenic carbon.
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Monitoramento de Radiação , Água , Oceano Índico , Trítio/análise , Água do Mar , CarbonoRESUMO
INTRODUCTION: The effect of the date of birth on the incidence of cardiovascular disease was confirmed in earlier studies. We aimed to determine whether the season of birth may be associated with a higher incidence of stroke in later life by analyzing thrombolysis numbers according over a ten-year period in Hungary. PATIENTS AND METHODS: We analyzed daily thrombolysis numbers between 2007 and 2016 according to the patients' date of birth based on seasons. The correlation between cumulative thrombolysis numbers between 2007 and 2016 per month and birth numbers per month based on data of the 1949 census were also examined. RESULTS: Our results indicate that being born in the spring and summer in the northern hemisphere may be associated with a higher frequency of ischemic stroke necessitating thrombolytic treatment. This equates to a higher risk when conception and early pregnancy occur in the summer and autumn months. CONCLUSIONS: This, however, cannot be defined as a causal relationship if we consider the number of live births in 1949, as both measures change similarly during the year, as indicated by the strong positive correlation between thrombolysis frequency according to date of birth between 2007 and 2016 and the number of births in the 1949 census by month.
TITLE: Fecha de nacimiento e incidencia del ictus isquémico agudo en Hungría.Introducción. El efecto de la fecha de nacimiento sobre la incidencia de enfermedad cardiovascular se ha confirmado en estudios anteriores. Nuestro objetivo fue determinar si la temporada de nacimiento puede estar asociada con una mayor incidencia de accidente cerebrovascular en etapas posteriores de la vida mediante el análisis de las cifras de trombólisis durante un período de 10 años en Hungría. Pacientes y métodos. Analizamos las cifras diarias de trombólisis entre 2007 y 2016 según la fecha de nacimiento de los pacientes según las estaciones. También se examinó la correlación entre las cifras de trombólisis acumuladas entre 2007 y 2016 por mes, y las cifras de nacimientos por mes según los datos del censo de 1949. Resultados. Nuestros resultados indican que nacer en primavera y verano en el hemisferio norte puede estar asociado con una mayor frecuencia de accidentes cerebrovasculares isquémicos que requieren tratamiento trombolítico. Esto equivale a un mayor riesgo cuando la concepción y el embarazo temprano ocurren en los meses de verano y otoño. Conclusión. Esto, sin embargo, no puede definirse como una relación causal si consideramos el número de nacidos vivos en 1949, ya que ambas medidas cambian de manera similar durante el año, como lo indica la fuerte correlación positiva entre la frecuencia de trombólisis según la fecha de nacimiento entre 2007 y 2016, y el número de nacimientos en el censo de 1949 por mes.
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Doenças Cardiovasculares , AVC Isquêmico , Feminino , Humanos , Hungria/epidemiologia , Incidência , Gravidez , Estações do AnoRESUMO
Improved methods for malaria diagnosis are urgently needed. Here, we evaluate a novel method named rotating-crystal magneto-optical detection (RMOD) in 956 suspected malaria patients in Papua New Guinea. RMOD tests can be conducted within minutes and at low cost. We systematically evaluate the capability of RMOD to detect infections by directly comparing it with expert light microscopy, rapid diagnostic tests and polymerase chain reaction on capillary blood samples. We show that compared to light microscopy, RMOD exhibits 82% sensitivity and 84% specificity to detect any malaria infection and 87% sensitivity and 88% specificity to detect Plasmodium vivax. This indicates that RMOD could be useful in P. vivax dominated elimination settings. Parasite density correlates well with the quantitative magneto-optical signal. Importantly, residual hemozoin present in malaria-negative patients is also detectable by RMOD, indicating its ability to detect previous infections. This could be exploited to reveal transmission hotspots in low-transmission settings.
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Testes Diagnósticos de Rotina/métodos , Malária/diagnóstico , Microscopia/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Hemeproteínas , Humanos , Malária/parasitologia , Malária Vivax/diagnóstico , Malária Vivax/parasitologia , Masculino , Pessoa de Meia-Idade , Dispositivos Ópticos , Papua Nova Guiné , Plasmodium vivax/genética , Reação em Cadeia da Polimerase/métodos , Sensibilidade e Especificidade , Adulto JovemRESUMO
Matrix product states and projected entangled pair states (PEPS) are powerful analytical and numerical tools to assess quantum many-body systems in one and higher dimensions, respectively. While matrix product states are comprehensively understood, in PEPS fundamental questions, relevant analytically as well as numerically, remain open, such as how to encode symmetries in full generality, or how to stabilize numerical methods using canonical forms. Here, we show that these key problems, as well as a number of related questions, are algorithmically undecidable, that is, they cannot be fully resolved in a systematic way. Our work thereby exposes fundamental limitations to a full and unbiased understanding of quantum many-body systems using PEPS.
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BACKGROUND: Traditional habitat knowledge, like the classification of folk habitats and how people partition their landscape into habitats, is an emerging but still understudied part of traditional ecological knowledge. Our objectives were to reconstruct the folk habitats and the partitioning of the landscape into these folk habitats by Mongolian herders in Northern Mongolia and to compare it with other Northern Hemisphere boreal-temperate classifications. METHODS: The study area is located in Seruun Gilad (Khuvsugul province) and belongs to the mountain forest steppe of the Khangai region (dominated by meadow steppes and larch forests). Most herder families use the area for summer pasturing. Data collection was based on indoor and outdoor, structured and semi-structured interviews and interviews during landscape walks and participatory fieldwork. We interviewed 20 people using 76+ photos of plant species and 25+ photos of habitats and asked them to name and describe the habitats and describe the habitat preferences of the species. RESULTS: Mongolian herders distinguished at least 88 folk habitat categories and knew well the habitat preferences of the 76 plant species. They argued that a herder has to be observant of nature. The habitat classification was moderately lexicalized, with many descriptive expressions. Most habitats (77%) belonged to the meso-scale, while macro-scale habitats (like taiga, Gobi) and micro-scale habitats (like marmot burrow, top of the tussock) were few. Habitat names did not reflect directly the usefulness of the habitat. Classification was multidimensional; key dimensions were geomorphological and edaphic. There were some species (e.g., botyuul, hyag, shireg) and species groups (hot plants, leafy plants) that were often used to describe habitat types. CONCLUSIONS: Landscape partitionings in the Northern Hemisphere differed considerably in the importance of various dimensions used, with edaphic, geomorphological, hydrological, and dominant species-based dimensions having higher importance, while land use, successional, and zoological dimensions having lower importance. We argue that conducting research on folk habitats will contribute to a deeper understanding of how nature is perceived by locals and to a more efficient management of the Mongolian pastures.
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Ecossistema , Etnobotânica , Conhecimento , Plantas/classificação , Humanos , MongóliaRESUMO
INTRODUCTION: The quality and function of movements undergo deterioration due to weight gain. Aerobic training normalizes body weight, improves the health status, and in addition, it is expected to improve the dynamics of movements. The aims of this study were to prove the beneficial effects of recreational physical activities on the movements. METHODS: Participants were divided into five different age categories: second childhood, adolescence, mature age I, mature age II, and aging. Squatting and vertical jumping of the participants were measured at the beginning and at the end of a 5-month training program. These movements simulated ordinary daily movements. Changes in the body were determined by InBody230. APAS 3D system was used for movement analysis. RESULTS: The results showed significant improvements in body weight, fat mass, muscle mass, fat mass-body weight ratio, muscle mass-body weight ratio, body mass index, body fat percentage, and waist-hip ratio. During jumping, the lifting and sinking of the center of gravity's (CG) position and its velocity and acceleration were improved. In case of squatting, the results showed significant improvements in the velocity and acceleration of dynamical characteristics of the CG. Other correlations were observed between changes in body composition and the dynamics of movements. DISCUSSION: The research proved that recreational training optimized body composition and improved the characteristics of CG's dynamics. The study suggests considerable connection between body composition and the characteristics of the movements' dynamics. From this point of view, our training program was the most effective in the working age groups.
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Exercício Físico/fisiologia , Aceleração , Adolescente , Adulto , Idoso , Composição Corporal/fisiologia , Índice de Massa Corporal , Peso Corporal/fisiologia , Criança , Feminino , Gravitação , Humanos , Masculino , Pessoa de Meia-Idade , Circunferência da Cintura/fisiologia , Adulto JovemRESUMO
The metalloid element, selenium (Se) is in many ways special and perhaps because of this its research in human and plant systems is of great interest. Despite its non-essentiality, higher plants take it up and metabolize it via sulfur pathways, but higher amounts of Se cause toxic symptoms in plants. However, the molecular mechanisms of selenium phytotoxicity have been only partly revealed; the data obtained so far point out that Se toxicity targets the plant proteome. Besides seleno- and oxyproteins, nitroproteins are also formed due to Se stress. In order to minimize proteomic damages induced by Se, certain plants are able to redirect selenocysteine away from protein synthesis thus preventing Se-protein formation. Additionally, the damaged or malformed selenoproteins, oxyproteins and nitroproteins may be removed by proteasomes. Based on the literature this review sets Se toxicity mechanisms into a new concept and it draws attention to the importance of Se-induced protein-level changes.
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Plantas/efeitos dos fármacos , Proteoma/metabolismo , Selênio/toxicidade , Proteínas de Plantas/metabolismo , Proteínas de Plantas/fisiologia , Plantas/metabolismo , Proteoma/fisiologia , Selênio/metabolismoRESUMO
Background: Schizophrenia is a chronic disease associated with significant and long-lasting effects on health, and it is also a social and financial burden, not only for patients but also for families, other caregivers, and the wider society. It is essential to conduct the assessment of indirect costs, to understand all the effects of the disease on society. Our aim is to gain a better understanding of the indirect costs of schizophrenia in Europe. Methods: We conducted a comprehensive systematic literature review covering EMBASE, Medline, and PsycINFO as well as reviewing Health Technology Assessment databases from different countries. We used a qualitative research synthesis for presenting information, as most of the studies were methodologically diverse, a quantitative analysis would have been impractical. Results: Indirect cost adjusted to inflation ranged vastly between studies included in the review from 119 Euros to 62, 034 Euros annually. The average proportion of indirect costs of total costs was 44%. Studies highlighted important cost drivers as age, gender, and disease severity, explaining the variation in costs between treatment and patient groups. Conclusions: Regardless of the methodological heterogeneity of the reviewed studies, there was an agreement about the significance of indirect costs of schizophrenia on the society. Considering the relatively high prevalence of schizophrenia in Europe, a need for more cost of illness studies especially from Central Eastern and Southern Europe is suggested.
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Efeitos Psicossociais da Doença , Custos de Cuidados de Saúde , Esquizofrenia/economia , Adolescente , Adulto , Idoso , Europa (Continente) , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
INTRODUCTION: High-flow priapism is infrequent in pediatric patients. It is mostly secondary to perineal trauma resulting in laceration of a penile artery and the formation of an arterio-cavernous fistula. It does not constitute a medical emergency in itself, and allows conservative management awaiting spontaneous resolution. CLINICAL CASE: A six-year-old boy with painless persistent erection preceded by perineal trauma. Ultrasound imaging confirmed the clinical suspicion of high flow priapism secondary to arterio-cavernous fistula. After adopting a conservative approach, the patient presented progressive detumescence, as well as ultrasound resolution one month after the episode. COMMENTS: In high-flow priapism, venous drainage of the penis is preserved. The classical approach in adults is based on therapeutic angiography, which presents greater technical complexity and the risk of iatrogenic hypoxia in pediatric patients.
INTRODUCCION: El priapismo de alto flujo es una entidad infrecuente en la edad pediátrica. Es, en su mayoría, secundario a traumatismo perineal que provoca la laceración de una arteria peneana y formación de una fístula arterio-cavernosa. No constituye una emergencia médica, permitiendo un manejo conservador a la espera de su resolución espontánea. CASO CLINICO: Niño de seis años con erección persistente e indolora tras traumatismo perineal. El diagnóstico ecográfico confirma la sospecha de priapismo de alto flujo secundario a fístula arteria-cavernosa. Tras manejo conservador, presenta detumescencia progresiva y resolución ecográfica al mes del episodio. COMENTARIOS: En el priapismo de alto flujo el drenaje venoso del pene se encuentra conservado. El manejo clásico en adultos se fundamenta en la angiografía terapéutica, de mayor complejidad técnica y riesgo de hipoxia iatrogénica en el paciente pediátrico.
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Tratamento Conservador/métodos , Fístula/complicações , Períneo/lesões , Priapismo/terapia , Criança , Humanos , Masculino , Pênis/irrigação sanguínea , Pênis/diagnóstico por imagem , Priapismo/diagnóstico por imagem , Priapismo/etiologia , UltrassonografiaRESUMO
In order to try to combat the effect of age on eggshell quality in aged laying hens, 5 split-feeding treatments were compared with conventional feeding between 75 and 92 wk of age. In the conventional treatment (T1), the same morning (M) and afternoon (A) diet was fed containing fine (FL) and coarse (CL) limestone at a 50:50 ratio. In the split treatments, the ratio of FL and CL was 50:50 or 30:70, and time of administration (M/A) differed. The following treatments were given: T2 = 50FL-M:50CL-A, T3 = 50CL-M:50FL-A, T4 = 30FL-M:20FL-A+50CL-A, T5 = 30FL-M:70CL-A, and T6 = 0M:30FL-A+70CL-A. A total of 12 individually housed Dekalb white hens was used per treatment. Feed intake, nutrient intake, and laying % was lower in T1 compared to all split treatments (P ≤ 0.001). Due to this low performance in T1, split feeding could not be compared to the conventional system in this trial. By the end of the trial, eggshell quality was improved in T1 as a result of low laying % and more frequent and longer laying pauses. In the split treatments, laying % and feed intake were similar, except in T3 in which a decrease was observed after 81 wk (P ≤ 0.05). Egg weight was higher in T5 and T6 due to higher total and morning protein intake compared to T3 (P ≤ 0.05). Feeding only 50FL-A in T3 not only resulted in lower performance but also in consistently lower shell thickness, indicating a negative effect of suboptimal limestone supplementation. In the split-feeding system, the most optimal combination of morning and afternoon diet was a morning diet with only FL and an afternoon diet with only CL (T2), which both provided â¼50% of the total daily Ca intake. Shell breaking strength and dynamic stiffness could be maintained on this diet between 75 and 92 weeks. Decreasing the amount of Ca in the morning and increasing it in the afternoon did not improve shell quality traits. Bone quality was not affected by limestone particle size or inclusion level in the split-feeding system.
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Ração Animal/análise , Criação de Animais Domésticos/métodos , Osso e Ossos/efeitos dos fármacos , Carbonato de Cálcio/metabolismo , Galinhas/fisiologia , Óvulo/efeitos dos fármacos , Animais , Osso e Ossos/fisiologia , Carbonato de Cálcio/efeitos adversos , Dieta/veterinária , Suplementos Nutricionais/análise , Feminino , Óvulo/fisiologia , Fatores de TempoRESUMO
The contribution of the intestinal tract to differences in residual feed intake (RFI) has been inconclusively studied in chickens so far. It is also not clear if RFI-related differences in intestinal function are similar in chickens raised in different environments. The objective was to investigate differences in nutrient retention, visceral organ size, intestinal morphology, jejunal permeability and expression of genes related to barrier function, and innate immune response in chickens of diverging RFI raised at 2 locations (L1: Austria; L2: UK). The experimental protocol was similar, and the same dietary formulation was fed at the 2 locations. Individual BW and feed intake (FI) of chickens (Cobb 500FF) were recorded from d 7 of life. At 5 wk of life, chickens (L1, n = 157; L2 = 192) were ranked according to their RFI, and low, medium, and high RFI chickens were selected (n = 9/RFI group, sex, and location). RFI values were similar between locations within the same RFI group and increased by 446 and 464 g from low to high RFI in females and males, respectively. Location, but not RFI rank, affected growth, nutrient retention, size of the intestine, and jejunal disaccharidase activity. Chickens from L2 had lower total body weight gain and mucosal enzyme activity but higher nutrient retention and longer intestines than chickens at L1. Parameters determined only at L1 showed increased crypt depth in the duodenum and jejunum and enhanced paracellular permeability in low vs. high RFI females. Jejunal expression of IL1B was lower in low vs. high RFI females at L2, whereas that of TLR4 at L1 and MCT1 at both locations was higher in low vs. high RFI males. Correlation analysis between intestinal parameters and feed efficiency metrics indicated that feed conversion ratio was more correlated to intestinal size and function than was RFI. In conclusion, the rearing environment greatly affected intestinal size and function, thereby contributing to the variation in chicken RFI observed across locations.
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Proteínas Aviárias/genética , Galinhas/fisiologia , Digestão , Metabolismo Energético , Regulação da Expressão Gênica , Imunidade Inata , Intestinos/fisiologia , Fenômenos Fisiológicos da Nutrição Animal , Animais , Áustria , Proteínas Aviárias/metabolismo , Galinhas/anatomia & histologia , Galinhas/genética , Galinhas/imunologia , Feminino , Geografia , Mucosa Intestinal/imunologia , Intestinos/anatomia & histologia , Jejuno/imunologia , Masculino , Irlanda do Norte , Tamanho do Órgão , Permeabilidade , Distribuição AleatóriaRESUMO
Purpose This study aims to compare the impact of active allergic rhinitis on physical and cognitive abilities of trained allergic athletes to untrained allergic patients. Methods Cognitive, respiratory, and fitness functions were assessed before and after allergen exposure. Participants in both groups were provoked intranasally with ragweed allergen. Results The group of athletes revealed significantly higher average values in peak inspiratory flow and fitness index before and after provocation. In neuropsychological assessments, athletes performed significantly better after allergen provocation in complex working memory capacity. Due to single acute allergen exposure, the size of the nasal cavity and nasal inspiratory peak flow significantly decreased in both groups. The physical performance of both groups did not change after provocation. Executive functions and complex working memory capacity of athletes significantly improved resulting from provocation. Conclusions A single-shot allergen in high dose might cause an increase in mental concentration, which was more pronounced in the group of athletes. This study indicates that acute exposure to allergen cannot affect the physical performance and may result in increased mental focus in patients with allergy notwithstanding the declining respiratory functions.
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Alérgenos/administração & dosagem , Antígenos de Plantas/administração & dosagem , Desempenho Atlético , Cognição/efeitos dos fármacos , Testes de Provocação Nasal/métodos , Extratos Vegetais/administração & dosagem , Desempenho Psicomotor/efeitos dos fármacos , Rinite Alérgica/fisiopatologia , Adulto , Relação Dose-Resposta a Droga , Esquema de Medicação , Feminino , Humanos , Masculino , Rinite Alérgica/diagnósticoRESUMO
1. The objective of this study was to investigate differences in growth performance, serum intermediary metabolites, acute-phase proteins and white blood cells in low, medium and high-residual feed intake (RFI) chickens. It was also assessed if the environment affects the feed efficiency (FE) and FE-related performance and serum profiles of chickens. 2. Individual body weight (BW) and feed intake (FI) were recorded from d 7 of life. At 5 weeks of age, female and male broiler chickens (Cobb 500) were selected according to their RFI (L1: Austria; L2: UK; n = 9/RFI group, sex and locatity -45on) and blood samples were collected. 3. Chickens at L1 had similar FI but a 15% higher BW gain compared to chickens at L2. The RFI values of female chickens were -231, 8 and 215 g and those of male chickens -197, 0 and 267 g for low, medium and high RFI, respectively. 4. Location affected serum glucose, urea, cholesterol, non-esterified fatty acids (NEFA) and ovotransferrin in females, and serum glucose and triglycerides in male chickens. Serum uric acid and NEFA linearly increased from low to high RFI in females, whereas in males, cholesterol showed the same linear response from low to high RFI. Serum alpha-1-acid glycoprotein and blood heterophil-to-lymphocyte ratio linearly increased by 35% and 68%, respectively, from low to high RFI but only in male chickens at L1. 5. Regression analysis showed significant positive relationships between RFI and serum uric acid (R2 = 0.49) and cholesterol (R2 = 0.13). 6. It was concluded that RFI-related variation in serum metabolites of chickens was largely similar for the two environments and that serum metabolite patterns could be used to predict RFI in chickens.
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Proteínas de Fase Aguda/metabolismo , Ração Animal/análise , Galinhas/fisiologia , Metabolismo Energético , Leucócitos/metabolismo , Animais , Galinhas/sangue , Galinhas/crescimento & desenvolvimento , Dieta/veterinária , Feminino , Masculino , Distribuição Aleatória , Aumento de PesoRESUMO
BACKGROUND/OBJECTIVES: Routine clinical care for Crohn's disease (CD) outpatients does not cover the assessment of body composition (BC); although this disease (because of inflammation, surgeries, lack of physical activity and appetite) may have a severe impact on lean body mass. The main aims of this prospective research were to assess the nutritional status of the patients and to compare their data with apparently healthy gender- and age-specific matched control pairs. SUBJECTS/METHODS: Overall, 136 CD patients and 1752 apparently healthy people were involved in the study. All participants were measured by the same bioelectrical impedance analyser. RESULTS: Using body mass index (BMI) and fat-free mass index (FFMI) as the markers of nutritional status, we found low BMI for 21% of the patients and low FFMI for 30% of them. Low BMI values were not gender specific, but substantially more females had low FFMI values. Low BMI was diagnosed in the patients' vs the control group for 21 vs 4% for men and 21 vs 2% for women; whereas low FFMI was diagnosed for 25 vs 5% for men and 36 vs 14% for women. Significant differences were found between patients' and control groups (median BMI: 22.0 vs 25.1 kg/m2, P<0.0001; FFMI: 17.3 vs 18.4 kg/m2, P=0.0044). CONCLUSIONS: This study confirmed the higher prevalence of low FFMI than that of low BMI among the subjects. We recommend implementing the assessment of BC into routine clinical care to diagnose low FFMI and to start intervention in time.
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Composição Corporal , Doença de Crohn/fisiopatologia , Adolescente , Adulto , Idoso , Índice de Massa Corporal , Estudos de Casos e Controles , Impedância Elétrica , Feminino , Humanos , Hungria , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Pacientes Ambulatoriais/estatística & dados numéricos , Estudos Prospectivos , Adulto JovemRESUMO
Summary: The Commission on Social Determinants of Health (CSDH) formulated recommendations along which health inequalities can be successfully tackled anywhere in the world. The situation of the Roma minority in Europe provides countless opportunities for the translation of these guidelines into action that should be guided by coherent and evidence-based strategies integrating lessons learned in smaller-scale field projects. Our paper describes the long-term evaluation of a locally initiated housing project in Hungary carried out more than a decade after implementation, which highlights the salience of the CSDH's recommendations and critical factors for success and sustainability. The project provides evidence for the long-term positive impact on education of the social housing project implemented by an empowered community through delegating decision making to a board of representatives of the beneficiaries in all decisions, including financial ones. Educational level greatly improved, and all housesinhabited by 17 out of 20 families who initially entered the projectremained in good condition, properly equipped and decorated after 13 years of implementation, in spite of an increase of unemployment during the same period which led to reduced income and deterioration of the families' economic situation. Better housing conditions for vulnerable people can be sustained and result in increased educational level if incremental improvement is aimed for and coupled with the redistribution of power at the local level.
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Escolaridade , Habitação , Roma (Grupo Étnico) , Tomada de Decisões , Família , Humanos , Hungria , Fatores SocioeconômicosRESUMO
Different ratios of fine- (FL) and coarse limestone (CL) were compared (50FL:50CL, 30FL:70CL, 0FL:100CL) in conventional (C) and split feeding (S) for their effects on performance, egg quality traits, and bone quality of old, brown laying hens (72 to 83 wk). Each treatment consisted of 42 hens (7 hens × 6 replicates). In the C system diets supplemented with limestone were provided during the whole day, whereas in the S system a morning diet was fed without added limestone, and only the afternoon diet was supplemented with different limestone ratios. Highest laying %, egg mass, and lowest feed conversion were found in the C system with 50FL:50CL and 0FL:100CL and in the S system with 30FL:70CL between 76 and 79 wk (P ≤ 0.001). Reduced cracked egg % was found when 0FL:100CL was supplemented in the C system and 30FL:70CL in the S system between 72 and 83 wk (P ≤ 0.001). Tibia ash content was higher in the S system compared to the C system (P = 0.005); tibia breaking strength, however, did not differ between feeding systems. Egg quality traits were not improved by S feeding. However, at 83 wk, S feeding resulted in higher breaking strength, but lower shell thickness compared to the C system (P = 0.036, P ≤ 0.001, respectively). Therefore, hens in the S feeding system might have been able to form a structurally superior shell compared to the C system. For further investigation, instead of restricting limestone supplementation solely to the afternoon, it might be a better approach to provide FL and CL at a different time of the d in a split feeding system to improve shell quality in old, brown laying hens in an extended production cycle.
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Ração Animal/análise , Carbonato de Cálcio , Galinhas/fisiologia , Suplementos Nutricionais/análise , Ovos/análise , Tíbia/química , Fatores Etários , Fenômenos Fisiológicos da Nutrição Animal , Animais , Dieta/veterinária , Feminino , Oviposição/fisiologia , Tamanho da Partícula , Tíbia/fisiologiaRESUMO
Purpose To explore patient safety culture among Romanian staff, using the U.S. Hospital Survey on Patient Safety Culture (HSOPSC). MATERIAL AND METHODS: A cross-sectional study was carried out in six hospitals, located in four Romanian regions (Craiova, Cluj-Napoca, Bucharest and Brasov), based on staff census in the Units/hospitals which volunteered to participate in the study (N=1,184). The response rate was 84%. The original questionnaire designed by the American Agency for Healthcare Research and Quality was translated into Romanian (with back translation), pre-tested before application and psychometrically checked. It consists of 42 questions grouped in 12categories, covering multiple aspects of patient safety culture (dimensions). Percentages of positive responses (PPRs) by question and category were analyzed overall and by staff profession. RESULTS: Most respondents were nurses (69%). The main work areas were surgery (24%) and medicine (22%). The highest PPRs were for Supervisor/Manager Expectations & Actions Promoting Safety (88%), Teamwork Within Units (86%), Handoffs and Transitions (84%), Organizational Learning-Continuous Improvement (81%), Overall Perceptions of Safety (80%), Feedback & Communication About Error (75%). The lowest PPRs were for: Staffing (39%), Frequency of Events Reported (59%) and Non-punitive Response to Errors (61%). Nurses exhibited significantly higher PPRs than doctors. CONCLUSIONS: This small-scale study of staff's attitude towards patient safety in Romanian hospitals suggests that there is room for future improvement, especially within the doctor category. Further research should assess the relationship between patient safety culture and frequency of adverse events.
RESUMO
Several feed efficiency (FE) metrics are currently used in livestock production to select for improved FE. Whether or not different FE metrics similarly estimate physiological characteristics in chickens of diverging FE has not been reported so far. This study aimed to assess potential differences in feed intake (FI), performance, and nutrient excretion in broiler chickens of diverging FE when ranked according to their residual FI (RFI), residual BW gain (RBG), RFI and BW gain (RIG), and G:F between d 7 and 35 of life. The FI was determined daily and BW was recorded once a week. The ranking of chickens into good, medium, and poor FE groups was completed separately for each FE metric. Freshly dropped excreta were collected for pH and DM measurements on d 30 to 32 of life and total excreta for determination of nutrient excretion was collected on d 34 to 36 of life. Relationships among FE metrics were evaluated using regression analysis showing that RFI, RIG, and G:F were more related to each other than to RBG. The FE values greatly varied among chickens for all FE metrics and chickens did not always cluster within the same FE group when using RFI, RIG, RBG, and G:F as the FE metrics because of the calculation approaches. Due to sex-related differences in performance, data of male and female chickens were analyzed separately. The RFI and RIG metrics showed a linear increase ( < 0.01) in total FI from good to poor FE in male and female chickens, whereas G:F showed this effect ( ≤ 0.011) only when BW gain was standardized to 1,500 g. The RBG did not clearly select chickens of enhanced total BW gain and only tended ( < 0.1) to select for greater BW gain from good to poor FE in female chickens. Excreta pH linearly decreased by 0.7 log units and DM content increased in males from good to poor FE when using RFI and RIG, respectively ( < 0.01). In both sexes, RFI ( < 0.05) and RIG metrics ( ≤ 0.06) showed a linear increase in daily nitrogen excretion from good to poor FE. In conclusion, results demonstrate that selection of the metric used to determine the FE of chickens modified the results obtained for comparison of production parameters and nutrient excretion among FE groups. Thereby, the RFI, RIG, and G:F metrics were beneficial in selecting the most feed efficient chickens to reduce feed costs, whereas the use of RFI and RIG may be better to select chickens with improved nitrogen retention and thus reduced excretion of an environmental pollutant.
Assuntos
Ração Animal/análise , Galinhas/fisiologia , Animais , Peso Corporal , Galinhas/crescimento & desenvolvimento , Dieta/veterinária , Ingestão de Alimentos/fisiologia , Fezes/química , Feminino , Masculino , Aumento de PesoRESUMO
1. A field study was conducted to investigate the deterioration of eggshell quality at the end of lay and examine the potential to extend the production cycle. A total of 1200 eggs were assessed originating from commercial farms in Belgium: eggs were random sampled at the collection belt at 57-65 weeks of age and at the end of the production cycle (74-92 weeks). 2. Based on a linear mixed model, egg quality was estimated for an average flock at 60 weeks of age and changes in quality traits were predicted until the end of the laying cycle. 3. Egg weight increased by 0.07 g every week from 60 weeks of age onwards and shape index decreased by 0.04 unit weekly (P < 0.001). Haugh unit values decreased weekly by 0.38 units whereas relative yolk weight was unaffected after 60 weeks of age. Relative albumen weight showed a weekly increase of 0.02% and relative shell decreased by 0.02% weekly until the end of lay. 4. Shell quality traits were also influenced by age: shell index decreased by 0.013 g weekly, shell thickness was calculated to be 0.23 µm thinner every week, deformation increased by 0.06 µm weekly from 60 weeks to the end of the laying cycle. Variability of the deformation of eggs indicated more heterogeneous shell quality at the end of the production cycle. Dynamic stiffness increased from 60 weeks of age on. 5. Laying hens were depopulated on average at 80 weeks of age (varying from 74-92 weeks). Although ageing had a significant effect on most of the egg quality traits, egg quality was still acceptable at the end of lay, indicating the potential to extend the laying cycle.