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1.
Nature ; 573(7773): 235-237, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31511683

RESUMEN

The Galactic Centre contains a supermassive black hole with a mass of four million Suns1 within an environment that differs markedly from that of the Galactic disk. Although the black hole is essentially quiescent in the broader context of active galactic nuclei, X-ray observations have provided evidence for energetic outbursts from its surroundings2. Also, although the levels of star formation in the Galactic Centre have been approximately constant over the past few hundred million years, there is evidence of increased short-duration bursts3, strongly influenced by the interaction of the black hole with the enhanced gas density present within the ring-like central molecular zone4 at Galactic longitude |l| < 0.7 degrees and latitude |b| < 0.2 degrees. The inner 200-parsec region is characterized by large amounts of warm molecular gas5, a high cosmic-ray ionization rate6, unusual gas chemistry, enhanced synchrotron emission7,8, and a multitude of radio-emitting magnetized filaments9, the origin of which has not been established. Here we report radio imaging that reveals a bipolar bubble structure, with an overall span of 1 degree by 3 degrees (140 parsecs × 430 parsecs), extending above and below the Galactic plane and apparently associated with the Galactic Centre. The structure is edge-brightened and bounded, with symmetry implying creation by an energetic event in the Galactic Centre. We estimate the age of the bubbles to be a few million years, with a total energy of 7 × 1052 ergs. We postulate that the progenitor event was a major contributor to the increased cosmic-ray density in the Galactic Centre, and is in turn the principal source of the relativistic particles required to power the synchrotron emission of the radio filaments within and in the vicinity of the bubble cavities.

2.
J Dairy Sci ; 105(1): 409-423, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34763915

RESUMEN

Adoption of optimal management techniques for rearing dairy calves has significant effects on their health, welfare, and productivity. Despite much published literature on best practice, calf morbidity and mortality rates remain high. This survey aimed to establish current calf management practices in the United Kingdom, along with farmer perceptions surrounding different housing types. A survey containing 48 questions was distributed online to UK farmers via social media, online forums, and a convenience sample of veterinary practices and was completed by 216 participants. A descriptive analysis with frequency distributions was calculated, with chi-squared tests, linear regression and multinomial regression performed to assess associations between variables. There was a low level of regular veterinary involvement in day-to-day health decision making for calves (3/216, 1.4%), highlighting the need for appropriate staff training and standard operating procedures to ensure prudent antimicrobial usage. Restricted calf milk feeding remains highly prevalent in the United Kingdom, with most calves fed milk replacer (114/216, 52.8%), twice daily (189/216, 87.5%), initially given milk at 4 L/d (66/216, 30.6%) or 6 L/d (47/216, 21.8%). There was, however, a small number of farmers initially feeding only 2 to 3 L/d (28/216, 13.0%). Euthanasia of bull calves (5/216, 2.3%) and feeding antimicrobial waste milk to calves (8/216, 3.7%) both occurred on some farms. With regard to housing, use of individual calf pens has reduced from around 60% in 2010 to 38.4% in this study (83/216), with this reduction being partly driven by the policy of UK milk buyers. Farmer perceptions indicated that individual housing was thought to help to improve calf health and feed monitoring of calves, suggesting that successful use of group housing requires a higher level of stockmanship. The majority of farmers did not provide fresh bedding to calves on a daily basis (141/216, 65.3%), and relatively few disinfected both the calf housing (38.0%) and ground (47.7%) between calves, suggesting that hygiene practices may require additional attention in farm management protocols.


Asunto(s)
Industria Lechera , Agricultores , Animales , Bovinos , Eutanasia Animal , Vivienda , Humanos , Masculino , Leche , Destete
3.
Gen Comp Endocrinol ; 313: 113889, 2021 11 01.
Artículo en Inglés | MEDLINE | ID: mdl-34425086

RESUMEN

Understanding baseline hormone levels, the magnitude of intra-individual variability, and their variation as a function of life history is difficult in toothed whales (e.g. dolphins and porpoises) because of the effects of capture stress. To determine the endocrine profile of the common bottlenose dolphin (Tursiops truncatus) as a function of season, time of day (TOD), age, sex, and reproductive status, blood corticosteroids, thyroid hormones, and catecholamines were repeatedly measured in a managed-care population exposed to ambient light and water temperatures of San Diego Bay. Additionally, fecal hormone metabolites were assessed for cortisol, aldosterone, and triiodothyronine. Samples were collected at two to four-week intervals over a period of two years, and multiple times within a day at monthly intervals over a year. Samples were collected through the voluntary participation of the dolphins in the blood draws and fecal collections in order to avoid the effects of handling stress. All serum hormones except aldosterone significantly varied with season and all serum hormones except total thyroxine significantly varied as a function of TOD. Fecal glucocorticoid metabolites significantly correlated with circulating cortisol levels, and there was a significant seasonal effect on triiodothyronine fecal metabolites. Strong seasonal effects demonstrated complex interactions with age and sex suggesting that contextual information is critical to interpreting differences in endocrine profiles. Strong circadian patterns further suggest that sampling design is important to the interpretation of blood or fecal collections, particularly since diurnal changes in some serum hormone levels are similar to the magnitude of seasonal differences. Despite potential impacts of feeding schedules on diurnal patterns, managed care populations can provide important insights into seasonal and age-related endocrine changes in toothed whales.


Asunto(s)
Delfín Mular , Animales , Sistema Endocrino/metabolismo , Hidrocortisona/metabolismo , Estaciones del Año , Tiroxina
4.
Climacteric ; 23(4): 388-396, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32648824

RESUMEN

Endometrial polyps have a reported prevalence from 7.8% up to 30% and are one of the most cost-consuming gynecological conditions for our specialty. There are strong practitioner beliefs that surgical removal of endometrial polyps is highly beneficial, particularly for those with abnormal uterine bleeding and infertility. Additionally, polypectomy is indicated to reduce the risk of malignancy. Transvaginal ultrasound is the first-line diagnostic option for detection of endometrial polyps, while sonohysterography has similar accuracy as hysteroscopy in the diagnostic confirmation. Blind dilatation and curettage is not recommended for polyp removal; rather, hysteroscopy in the operating room and office setting using small-diameter hysteroscopic equipment is the standard approach. This can be performed without anesthesia in most women. While hysteroscopy is an effective method for polypectomy with a low complication rate, it is unknown whether this is truly beneficial for reproductive-age women with infertility and prior assisted reproduction therapy. The risk of malignancy in women with postmenopausal bleeding justifies the necessity of polypectomy with histologic tissue examination. In asymptomatic women, the risk of malignancy is low, and there are no known benefits of polyp removal in the prevention of malignant transformation. Cost-effective studies remain to be done to provide us with the optimal approach to endometrial polyps including the management of asymptomatic and/or infertile women, ideal location including office-based or the operating room setting, complication prevention including intrauterine adhesions, and recurrence issues.


Asunto(s)
Histeroscopía/métodos , Pólipos/cirugía , Neoplasias Uterinas/cirugía , Adulto , Manejo de la Enfermedad , Femenino , Humanos , Infertilidad Femenina/etiología , Infertilidad Femenina/cirugía , Persona de Mediana Edad , Pólipos/complicaciones , Embarazo , Hemorragia Uterina/etiología , Hemorragia Uterina/cirugía , Neoplasias Uterinas/complicaciones
5.
Anaesthesia ; 75(4): 479-486, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32037522

RESUMEN

Cell salvage is an important component of blood management in patients undergoing revision hip arthroplasty surgery. However concerns regarding efficacy and patient selection remain. The aims of this study were to describe intra-operative blood loss, cell salvage re-infusion volumes and red blood cell transfusion rates for revision hip procedures and to identify factors associated with the ability to salvage sufficient blood intra-operatively to permit processing and re-infusion. Data were collected from a prospective cohort of 664 consecutive patients undergoing revision hip surgery at a single tertiary centre from 31 March 2015 to 1 April 2018. Indications for revision surgery were aseptic (n = 393 (59%)) fracture (n = 160 (24%)) and infection (n = 111 (17%)). Salvaged blood was processed and re-infused when blood loss exceeded 500 ml. Mean (SD) intra-operative blood loss was 1038 (778) ml across all procedures. Salvaged blood was re-infused in 505 of 664 (76%) patients. Mean (SD) re-infusion volume was 253 (169) ml. In total, 246 of 664 (37%) patients received an allogeneic red blood cell transfusion within 72 h of surgery. Patients undergoing femoral component revision only (OR (95%CI) 0.41 (0.23-0.73)) or acetabular component revision only (0.53 (0.32-0.87)) were less likely to generate sufficient blood salvage volume for re-infusion compared with revision of both components. Compared with aseptic indications, patients undergoing revision surgery for infection (1.87 (1.04-3.36)) or fracture (4.43 (2.30-8.55)) were more likely to generate sufficient blood salvage volume for re-infusion. Our data suggest that cell salvage is efficacious in this population. Cases where the indication is infection or fracture and where both femoral and acetabular components are to be revised should be prioritised.


Asunto(s)
Artroplastia de Reemplazo de Cadera/métodos , Transfusión de Sangre Autóloga/métodos , Cuidados Intraoperatorios/métodos , Recuperación de Sangre Operatoria/métodos , Reoperación/métodos , Anciano , Estudios de Cohortes , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos
6.
Soc Psychiatry Psychiatr Epidemiol ; 51(2): 193-202, 2016 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-26190152

RESUMEN

PURPOSE: Population-level surveys suggest that anxiety has been increasing in several nations, including the USA and UK. We sought to verify the apparent anxiety increases by looking for systematic changes in mean anxiety questionnaire scores from research publications. METHODS: We analyzed all available mean State-Trait Anxiety Inventory scores published between 1970 and 2010. We collected 1703 samples, representing more than 205,000 participants from 57 nations. RESULTS: Results showed a significant anxiety increase worldwide, but the pattern was less clear in many individual nations. Our analyses suggest that any increase in anxiety in the USA and Canada may be limited to students, anxiety has decreased in the UK, and has remained stable in Australia. CONCLUSIONS: Although anxiety may have increased worldwide, it might not be increasing as dramatically as previously thought, except in specific populations, such as North American students. Our results seem to contradict survey results from the USA and UK in particular. We do not claim that our results are more reliable than those of large population surveys. However, we do suggest that mental health surveys and other governmental sources of disorder prevalence data may be partially biased by changing attitudes toward mental health: if respondents are more aware and less ashamed of their anxiety, they are more likely to report it to survey takers. Analyses such as ours provide a useful means of double-checking apparent trends in large population surveys.


Asunto(s)
Ansiedad/epidemiología , Salud Global/estadística & datos numéricos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudiantes/psicología , Estudiantes/estadística & datos numéricos , Encuestas y Cuestionarios , Adulto Joven
8.
Phys Rev Lett ; 113(14): 147203, 2014 Oct 03.
Artículo en Inglés | MEDLINE | ID: mdl-25325655

RESUMEN

The nature of near-surface spin canting within Fe3O4 nanoparticles is highly debated. Here we develop a neutron scattering asymmetry analysis which quantifies the canting angle to between 23° and 42° at 1.2 T. Simultaneously, an energy-balance model is presented which reproduces the experimentally observed evolution of shell thickness and canting angle between 10 and 300 K. The model is based on the concept of Td site reorientation and indicates that surface canting involves competition between magnetocrystalline, dipolar, exchange, and Zeeman energies.


Asunto(s)
Nanopartículas de Magnetita/química , Modelos Químicos , Materiales Biocompatibles/química , Óxido Ferrosoférrico/química , Magnetometría/métodos , Propiedades de Superficie , Temperatura , Termodinámica
9.
J Phys Chem A ; 118(18): 3211-29, 2014 May 08.
Artículo en Inglés | MEDLINE | ID: mdl-24758210

RESUMEN

We investigate the photolytic production of two radical intermediates in the reaction of OH with propene, one from addition of the hydroxyl radical to the terminal carbon and the other from addition to the center carbon. In a collision-free environment, we photodissociate a mixture of 1-bromo-2-propanol and 2-bromo-1-propanol at 193 nm to produce these radical intermediates. The data show two primary photolytic processes occur: C-Br photofission and HBr photoelimination. Using a velocity map imaging apparatus, we measured the speed distribution of the recoiling bromine atoms, yielding the distribution of kinetic energies of the nascent C3H6OH radicals + Br. Resolving the velocity distributions of Br((2)P(1/2)) and Br((2)P(3/2)) separately with 2 + 1 REMPI allows us to determine the total (vibrational + rotational) internal energy distribution in the nascent radicals. Using an impulsive model to estimate the rotational energy imparted to the nascent C3H6OH radicals, we predict the percentage of radicals having vibrational energy above and below the lowest dissociation barrier, that to OH + propene; it accurately predicts the measured velocity distribution of the stable C3H6OH radicals. In addition, we use photofragment translational spectroscopy to detect several dissociation products of the unstable C3H6OH radicals: OH + propene, methyl + acetaldehyde, and ethyl + formaldehyde. We also use the angular momenta of the unstable radicals and the tensor of inertia of each to predict the recoil kinetic energy and angular distributions when they dissociate to OH + propene; the prediction gives an excellent fit to the data.

10.
Gen Comp Endocrinol ; 195: 174-82, 2014 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-24239792

RESUMEN

We validate fecal glucocorticoid (GC) and thyroid (T3) hormone metabolite measures in the Critically Endangered Hawaiian monk seal for the first time, and examine variation in the concentrations of these hormones in individuals across the species' range. We test hypotheses that monk seals from declining subpopulations have relatively high GCs and low T3 on average suggesting impacts of food limitation, and that this hormone pattern is more apparent in immature animals compared to adults, as food limitation is specifically indicated as a principal cause of poor body condition and survival of juvenile monk seals. We opportunistically sampled scat from 84 individually identifiable monk seals during the 2010 breeding season from two geographic regions, the main Hawaiian Islands (MHI) and the Northwestern Hawaiian Islands (NWHI). The MHI subpopulation of monk seals is growing, whereas subpopulations at many sites in the NWHI are in decline. Best fit general linear models predicting variation in GCs and T3 (examined separately) were similar (after accounting for significantly elevated hormone concentrations associated with molt and possibly lactation); both included sample date, region, and monk seal age as predictors. GC concentrations were significantly lower in MHI versus NWHI monk seals and decreased as the breeding season progressed. T3 concentrations were significantly lower in immature monk seals compared to adults. GC and T3 concentrations were positively correlated at 4 NWHI sites; prey may be adequate for physiological growth or maintenance at these sites but relatively stressful to acquire. GCs were highest at French Frigate Shoals, (a NWHI site) while T3 was relatively low here, indicating a possible signal of food limitation. GCs were lowest in the MHI. Disturbance associated with living near a high human population in the MHI appears to impact monk seal physiology less than other stressors encountered in the remote and highly protected NWHI where human presence is extremely low.


Asunto(s)
Heces/química , Glucocorticoides/análisis , Radioinmunoensayo/métodos , Phocidae/metabolismo , Estaciones del Año , Hormonas Tiroideas/análisis , Animales , Glucocorticoides/metabolismo , Humanos , Hormonas Tiroideas/metabolismo
11.
J R Nav Med Serv ; 100(3): 321-7, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25895414

RESUMEN

The right to make an informed choice about contraception should be afforded to every individual serving within the United Kingdom (UK) Armed Forces. This article looks at the responsibilities and approach that healthcare professionals should take within a Primary Care setting, summarises the common contraceptive options available, discusses the associated advantages and disadvantages of each technique, and considers operational factors in a military environment that combine to influence the final contraceptive choice an individual makes. Case Study. A 19-year old Able Rate joined the Royal Navy (RN) and at her joining medical it was noted that she had been on Microgynon™ combined oral contraceptive pill for approximately three years. During this time, her menstrual periods remained light; she never experienced adverse effects, demonstrated good compliance, and was happy to remain on this contraceptive regimen. Over the course of the next eighteen months, she was reviewed by a number of Medical Officers and Civilian Medical Practitioners on a quarterly basis, with Microgynon™ re-prescribed on each occasion. The appropriate Defence Medical Information Capability Programme (DMICP) template was used, with weight, smoking status, compliance and any issues or comments documented accordingly. In December 2010, a discussion regarding long-acting reversible contraception (LARC) was documented for the first time. The patient agreed to give LARC some thought and a review appointment was made for one month. She was subsequently started on the progestogen-only pill Cerazette™. It was noted by the consulting doctor that both the patient's mother and grandmother had a positive history of cerebrovascular events and the combined oral contraceptive pill was discontinued. Upon review at two months, the patient reported that she was content on Cerazette™ and wished to continue with this medication. She was amenorrhoeic, highly compliant, had given up smoking and her weight and blood pressure were stable. However, due to supply issues, it was explained that Cerazette™ was no longer a viable option for her. She had no plans to start a family, and was keen to investigate other contraceptive options. Furthermore, she expressed a particular desire to remain amenorrhoeic, as she was due to deploy overseas in the coming months, and not only wanted to avoid the inconvenience of having her period, but also felt it preferable not to have to take a daily pill when considering the constantly changing time zones. She subsequently had the etonogestrel-releasing subdermal implant Nexplanon™ fitted without complication. She has remained amenorrhoeic throughout and this form of long-acting reversible contraception has particularly suited her busy working role and active lifestyle.


Asunto(s)
Anticoncepción , Anticonceptivos Femeninos/administración & dosificación , Dispositivos Anticonceptivos , Personal Militar , Anticonceptivos Femeninos/efectos adversos , Toma de Decisiones , Femenino , Humanos , Navíos
12.
Artículo en Inglés | MEDLINE | ID: mdl-38780870

RESUMEN

BACKGROUND: Undergraduate students are particularly in need of mental health support, but demand has far surpassed resources. This gap between mental health diagnoses and support is particularly large among Asian, Hispanic/Latinx, and Black students. Supplementing on-campus care with a virtual-only behavioral health partner may shift these trends. OBJECTIVE: This study is aimed at comparing the number of undergraduate students from different racial/ethnic groups (White, Asian, Islander, Hispanic/Latinx, Black, Native, and Multiracial) engaging in virtual mental health visits as part of a partnership with a company providing virtual-only care, with the total enrolled undergraduate students at the same 113 institutions. METHODS: We used de-identified visit data and self-reported race/ethnicity to define the "patient" population of undergraduates accessing care. We compared that to the full "student" population of undergraduates among the same schools, available as part of the Integrated Postsecondary Education Data System (IPEDS). RESULTS: Patient population race/ethnicity (N = 14,870) differed significantly from student population race/ethnicity (N = 619,459). A significant effect ( χ 26 = 2258, P < .001) indicated that patient demographics differed from student demographics. We found proportionally more Asian, Black, and Multiracial patients than students. At the same time, we found proportionally fewer White and Hispanic/Latinx patients than students. CONCLUSIONS: We conclude that, in contrast to prior literature in traditional mental health care, some racial/ethnic minority undergraduates (Asian, Black, and Multiracial) may actually access care at a higher rate under a fully virtual model. On the other hand, White and Hispanic/Latinx students may access care less frequently.

13.
Prev Vet Med ; 213: 105870, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-36841042

RESUMEN

Antimicrobial resistance (AMR) is a growing One Health problem. Monitoring antimicrobial usage in farm animals is crucial for tackling AMR. A cohort study using the electronic clinical records during 2019 from 23 farm animal veterinary practices across the UK belonging to two corporate groups, with a range of 2-14 veterinarians per practice, estimated the usage of antimicrobials and highest priority critically important antimicrobials (HP-CIAs). Risk factors for using HP-CIAs were evaluated using hierarchical mixed-effects logistic regression modelling with practice ID and farm ID added as random effects. Using a qualitative approach, veterinarians from one of the participating practice groups were recruited for a qualitative study to explore the barriers and facilitators in relation to antimicrobial use. Semi-structured interviews were conducted with participants and analysed thematically. During the year 2019, 98,824 antimicrobial prescribing events overall were recorded from the treatment records of the 23 participating practices. The median count of antimicrobial events per practice was 3226 (range 263-22,159). There were 17,111/98,824 (17.3%) HP-CIAs events overall, with a median of 15.4% at practice level (range 4.8-22.1%). Penicillins were the most frequently used antimicrobials 29,539/98,824 (29.9%) followed by tetracyclines 19,015/98,824 (19.2%). HP-CIA use was strongly clustered, with more clustering seen at the farm level (intraclass correlation coefficient (ICC)= 0.56) than at the practice level (ICC= 0.32). Country, route of administration, season and practice type were significantly associated with the usage of HP-CIAs. Four main themes were identified from the analysis of the veterinarians' interviews: pressure from the industry, drug-related factors, knowledge level of veterinarians and clinical factors. Supermarket contracts and farm assurance schemes were facilitators for reducing antimicrobial use and the use of HP-CIAs. Ease of administration and the withdrawal period of the antimicrobials influenced veterinarians' choice of antimicrobials. The clinical condition and clinical signs presented on farm were reported to influence participating veterinarians' prescribing decision. Participants showed a good understanding of AMR, responsible use of antimicrobials and the term 'critically important antimicrobials'. In conclusion, integrating the quantitative and qualitative findings can inform policymaking on antimicrobials stewardship in farm practice. By estimating the relative levels of clustering of antimicrobial use at the practice and farm level, as well as identifying major risk factors for using HP-CIAs, more targeted interventions can be designed to promote responsible antimicrobial use in farm practice. Furthermore, better understanding the industry pressures on farms to reduce antimicrobials usage could reduce the barriers for responsible antimicrobial use by veterinarians.


Asunto(s)
Antiinfecciosos , Veterinarios , Animales , Animales Domésticos , Estudios de Cohortes , Antiinfecciosos/uso terapéutico , Antibacterianos/uso terapéutico , Reino Unido
14.
Inquiry ; 60: 469580221148880, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36680364

RESUMEN

The COVID-19 pandemic increased social isolation for many older adults, causing concern for their health and well-being. To enhance understanding of how community-dwelling older adults were impacted by prolonged social isolation during COVID-19, a qualitative descriptive study was conducted to: (1) explore the self-reported factors supporting their resilience during COVID-19 related social isolation, and (2) to help understand the intentional and unintentional outcomes of the government mandated health measures. A total of 19 community dwelling older adults were sampled. Factors that supported older adults' resilience during COVID-19 included maintaining positivity, drawing on historical experiences of resilience and finding opportunities to connect with their community. However, collective safety came with losses: such as time, freedom, opportunity, engagement, and initiative. The findings provide insight on contributing factors to resilience against social isolation in older adults and suggest the value of collective, community-based approaches to build resilience across variable contexts in this population.


Asunto(s)
COVID-19 , Humanos , Anciano , Vida Independiente , Pandemias , Aislamiento Social , Gobierno
15.
Trials ; 24(1): 84, 2023 Feb 06.
Artículo en Inglés | MEDLINE | ID: mdl-36747305

RESUMEN

BACKGROUND: Advanced practice physiotherapy (APP) models of care where physiotherapists are primary contact emergency department (ED) providers are promising models of care to improve access, alleviate physicians' burden, and offer efficient centered patient care for patients with minor musculoskeletal disorders (MSKD). OBJECTIVES: To compare the effectiveness of an advanced practice physiotherapist (APPT)-led model of care with usual ED physician care for persons presenting with a minor MSKD, in terms of patient-related outcomes, health care resources utilization, and health care costs. METHODS: This trial is a multicenter stepped-wedge cluster randomized controlled trial (RCT) with a cost analysis. Six Canadian EDs (clusters) will be randomized to a treatment sequence where patients will either be managed by an ED APPT or receive usual ED physician care. Seven hundred forty-four adults with a minor MSKD will be recruited. The main outcome measure will be the Brief Pain Inventory Questionnaire. Secondary measures will include validated self-reported disability questionnaires, the EQ-5D-5L, and other health care utilization outcomes such as prescription of imaging tests and medication. Adverse events and re-visits to the ED for the same complaint will also be monitored. Health care costs will be measured from the perspective of the public health care system using time-driven activity-based costing. Outcomes will be collected at inclusion, at ED discharge, and at 4, 12, and 26 weeks following the initial ED visit. Per-protocol and intention-to-treat analyses will be performed using linear mixed models with a random effect for cluster and fixed effect for time. DISCUSSION: MSKD have a significant impact on health care systems. By providing innovative efficient pathways to access care, APP models of care could help relieve pressure in EDs while providing efficient care for adults with MSKD. TRIAL REGISTRATION: ClinicalTrials.gov NCT05545917 . Registered on September 19, 2022.


Asunto(s)
Enfermedades Musculoesqueléticas , Adulto , Humanos , Canadá , Enfermedades Musculoesqueléticas/diagnóstico , Enfermedades Musculoesqueléticas/terapia , Costos de la Atención en Salud , Modalidades de Fisioterapia , Servicio de Urgencia en Hospital
16.
Gen Comp Endocrinol ; 172(3): 382-91, 2011 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-21501613

RESUMEN

Climate change and industrial development are contributing to synchronous declines in Rangifer populations across the Arctic. Chronic stress has been implicated as a proximate factor associated with decline in free-ranging populations, but its role in Rangifer is unspecified. Analysis of glucocorticosteroid (GC) concentration in feces, and more recently in hair, is a non-invasive method for monitoring stress in wildlife. Adrenocorticotropic hormone (ACTH) released from the pituitary gland stimulates GC release from the adrenals and can be administered to reflect adrenal activation. In this study, we assessed concentrations of GC metabolites in feces and cortisol in hair of Alaskan caribou (Rangifer tarandus granti) and reindeer (R. t. tarandus) following ACTH treatment. We predicted that ACTH challenge would increase concentrations of fecal GCs, but not hair cortisol because steroid deposited into the hair shaft occurs over an extended period of time (months) and is likely insensitive to acute adrenal stimulation. Adult caribou (n=10; mean age, 6.5 years old) exhibited a peak increase in fecal GCs 8h following a 2 IU/kg dose of ACTH compared to pre-injection concentrations. In contrast, sub-adult reindeer (n=10, 0.8 years old) elicited a diminished response to the same dose. Quadrupling the dose (8 IU/kg) prolonged the fecal GC response in female reindeer, but male reindeer were unresponsive. Hair cortisol was unaffected by a single ACTH challenge. Further investigation is required to ascertain whether subspecific differences in adrenal sensitivity are attributed to age or sex differences, or historical selective pressures from semi-domestication and/or sedentary life cycle in reindeer.


Asunto(s)
Hormona Adrenocorticotrópica/farmacología , Ciervos/metabolismo , Heces/química , Glucocorticoides/metabolismo , Cabello/química , Reno/metabolismo , Animales , Ciervos/fisiología , Femenino , Hidrocortisona/sangre , Masculino , Reno/fisiología , Estrés Fisiológico
17.
Zootaxa ; 4970(3): 533546, 2021 May 17.
Artículo en Inglés | MEDLINE | ID: mdl-34186881

RESUMEN

Life stages of Henosepilachna implicata (Mulsant), an economically important species of Epilachnini in India, are documented and illustrated. Mitochondrial DNA sequence data is provided for the first time for H. implicata with additional details on its host plants, distribution, and natural enemies. Its similarities and differences with other common pestiferous Henosepilachna spp. in India such as H. vigintioctopunctata (F.), H. septima (Dieke) and H. pusillanima (Mulsant) are discussed. Epilachna circularis Korschefsky, 1933 is found to be conspecific with H. implicata and is reduced to a junior synonym of the latter (new synonym). Notes are given on the distribution and natural enemies of some other species of Epilachnini of the Indian region.


Asunto(s)
Escarabajos/clasificación , Animales , Secuencia de Bases , ADN Mitocondrial , Plantas
18.
J Exp Med ; 158(3): 822-35, 1983 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-6604127

RESUMEN

Several previously described B cell growth factor (BCGF) activities from a number of mouse monoclonal T cell sources were compared in different functional assays. The results indicate that there are two distinct classes of BCGF defined by functional activity and source. BCGF I, whose prototype is (EL4)BCGF, synergized with anti-Ig in the proliferation of normal splenic B cells but had no activity when dextran sulfate (DXS), rather than anti-Ig, was used to costimulate the same source of B cells. BCGF I also failed to directly stimulate BCL1 tumor B cells. In contrast, BCGF II, whose prototype is (DL)BCGF, showed a reciprocal pattern of activity. BCGF II failed to synergize with anti-Ig-costimulated normal B cells to give good proliferative responses. Sources of BCGF II also directly stimulated (no anti-Ig or DXS added) B cells of the BCL1 tumor-carrying mice. These results suggest that the two BCGF may have activity on two subsets of B cells that respond differentially to induction with the two polyclonal B cell activators, anti-Ig and DXS. The possibilities that these different patterns of response occur in separate lineages of B cells and/or in B cells in different states of differentiation is discussed.


Asunto(s)
Linfocitos B/clasificación , Sustancias de Crecimiento/clasificación , Activación de Linfocitos , Animales , Anticuerpos Antiidiotipos/fisiología , Linfocitos B/citología , Linfocitos B/inmunología , Diferenciación Celular , Línea Celular , Sinergismo Farmacológico , Sustancias de Crecimiento/fisiología , Interleucina-4 , Interfase , Ratones , Ratones Endogámicos BALB C , Ratones Endogámicos C57BL , Ratones Endogámicos CBA , Ratones Endogámicos DBA
19.
Phys Rev Lett ; 114(14): 149702, 2015 Apr 10.
Artículo en Inglés | MEDLINE | ID: mdl-25910168
20.
Phys Rev Lett ; 104(20): 207203, 2010 May 21.
Artículo en Inglés | MEDLINE | ID: mdl-20867056

RESUMEN

A new development in small-angle neutron scattering with polarization analysis allows us to directly extract the average spatial distributions of magnetic moments and their correlations with three-dimensional directional sensitivity in any magnetic field. Applied to a collection of spherical magnetite nanoparticles 9.0 nm in diameter, this enhanced method reveals uniformly canted, magnetically active shells in a nominally saturating field of 1.2 T. The shell thickness depends on temperature, and it disappears altogether when the external field is removed, confirming that these canted nanoparticle shells are magnetic, rather than structural, in origin.


Asunto(s)
Magnetismo , Nanopartículas de Magnetita/química , Difracción de Neutrones , Dispersión del Ángulo Pequeño , Temperatura
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