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Certified reference material (CRM) for natural (40K,210Pb,210Po,226Ra,228Ra,228Th,230Th,232Th,234U,235U, and238U) and anthropogenic (137Cs,239+240Pu, and241Am) radionuclides in marine sediment from the Baltic Sea (IAEA-465) has been developed. Information values are given for 238Pu,239Pu and240Pu. Altogether 27 laboratories participated in this exercise. Radiometric (alpha-spectrometry, gamma-spectrometry and beta counting, as well as mass spectrometry (ICP-MS and AMS) techniques were applied in measurements. The CRM is intended to be used for Quality Assurance/Quality Control of radionuclide analyses, for the development and validation of analytical methods, for the development of reference methods and for training purposes.
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Sedimentos Geológicos , Monitoramento de Radiação , Poluentes Radioativos da Água , Sedimentos Geológicos/química , Poluentes Radioativos da Água/análise , Plutônio/análise , Padrões de Referência , Radioisótopos/análise , Radioisótopos de Césio/análise , Tório/análiseRESUMO
INTRODUCTION: Palliative care focuses on improving patient and family quality of life by managing symptoms, psychosocial issues and spiritual concerns. Huntington's disease is a progressive neurodegenerative disorder with no current disease modifying therapy. Although the palliative care model has been postulated to be an integral part of HD care, there are gaps in knowledge about how this care should be implemented. This study aims to identify perceptions of palliative care in Huntington's Disease (HD), palliative care needs of people living with HD, and at what point they feel they would benefit from these resources. METHODS: Participants volunteered from a large academic institution patient base to be involved in semi structured interviews that explored patient and caregiver experience surrounding their diagnosis, disease management, quality of life, and areas for improvement. Inclusion criteria for participants was a diagnosis of Huntington's disease and/or a self-identified caregiver of a person living with the disease. RESULTS: A total of 12 independent patients, three independent caregivers, and five dyads completed the interviews. Themes identified included needs that would provide patient and caregiver centered treatment, current gaps in care, an openness and desire for palliative care, and knowledge about the desired timing of palliative care in treatment plans. CONCLUSION: People living with HD and caregivers of people with HD most desire access to treatment that would focus on symptom management, availability of social resources, advanced care planning and spiritual wellbeing. The preferred timing of this intervention for most individuals would be at the onset of symptoms.
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Doença de Huntington , Cuidados Paliativos , Humanos , Doença de Huntington/terapia , Doença de Huntington/psicologia , Qualidade de Vida , Pesquisa Qualitativa , Cuidadores/psicologiaRESUMO
BACKGROUND: Among people with hip and knee osteoarthritis (OA), increasing deprivation is associated with reduced likelihood of receiving hip and knee arthroplasty (THA, TKA). OBJECTIVES: To assess whether higher levels of frailty in the most deprived neighbourhoods explains the association between greater neighbourhood deprivation and reduced likelihood of receiving THA and TKA among people with hip and knee OA. DESIGN: Longitudinal cohort study. SETTING: Linked primary and secondary care electronic medical records and national mortality data. PARTICIPANTS: 104,913 individuals with incident hip OA and 216,420 with incident knee OA. MEASUREMENTS: Frailty was assessed using a frailty index and categorised as fit, mild, moderate, and severe frailty. Neighbourhood deprivation was assessed using the index of multiple deprivation (IMD). RESULTS: Compared to those in neighbourhoods in the least deprived quintile of IMD, those in neighbourhoods in the fourth and fifth quintile of IMD (most deprived), respectively, were less likely to receive THA, adjusted subhazard ratio (95% CI), 0.90 (0.87, 0.93) and 0.77 (0.74, 0.80), over a mean follow up of 4.4 years, with similar results for TKA. Higher levels of frailty at OA diagnosis were associated also with reduced likelihood of receiving THA and TKA. The association, however, between deprivation and likelihood of receiving THA and TKA could not be explained by increased levels of frailty among those living in the most deprived areas. CONCLUSIONS: Further work is needed to understand why those in the most deprived areas are less likely to receive THA and TKA.
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Artroplastia de Quadril , Artroplastia do Joelho , Fragilidade , Osteoartrite do Quadril , Osteoartrite do Joelho , Humanos , Osteoartrite do Joelho/epidemiologia , Osteoartrite do Joelho/cirurgia , Osteoartrite do Quadril/epidemiologia , Osteoartrite do Quadril/cirurgia , Estudos LongitudinaisRESUMO
Branched copolymer surfactants (BCS) containing thermoresponsive polymer components, hydrophilic components, and hydrophobic termini allow the formation of emulsions which switch from liquid at room temperature to a gel state upon heating. These materials have great potential as in situ gel-forming dosage forms for administration to external and internal body sites, where the emulsion system also allows effective solubilisation of a range of drugs with different chemistries. These systems have been reported previously, however there are many challenges to translation into pharmaceutical excipients. To transition towards this application, this manuscript describes the evaluation of a range of pharmaceutically-relevant oils in the BCS system as well as evaluation of surfactants and polymeric/oligomeric additives to enhance stability. Key endpoints for this study are macroscopic stability of the emulsions and rheological response to temperature. The effect of an optimal additive (methylcellulose) on the nanoscale processes occurring in the BCS-stabilised emulsions is probed by small-angle neutron scattering (SANS) to better comprehend the system. Overall, the study reports an optimal BCS/methylcellulose system exhibiting sol-gel transition at a physiologically-relevant temperature without macroscopic evidence of instability as an in situ gelling dosage form.
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Temperatura Corporal , Polímeros , Emulsões/química , Temperatura , Hidrogéis/química , Tensoativos , Metilcelulose/químicaRESUMO
BACKGROUND: The Prostate Cancer Cohort Consortium (PC3) Working Group proposed a definition for aggressive prostate cancer (PC) for aetiologic epidemiologic research. We aimed to validate this definition as well as a second approach utilising only information on stage at diagnosis. METHODS: First primary PCs diagnosed 2004 - 2009 in the population-based Janus Serum Bank (JSB) cohort were identified by linkage to the population-based Cancer Registry of Norway (CRN) (n = 3568). The CRN and Norwegian Prostate Cancer Registry provided clinicopathological data for these cases. Approach 1 classified PC as aggressive if it was clinically T4, or N1, or M1, or had a Gleason score ≥8 at diagnosis (as proposed). Approach 2 classified PC as aggressive if CRN stage at diagnosis was 'regional spread' or 'distant metastases'. Both approaches were validated by calculating the sensitivity and positive predictive value (PPV) against PC-death within 10 years of diagnosis. RESULTS: Overall, 555 died from PC within 10 years. Approach 1 classified 24.7% of cases as aggressive and 13.6% were unclassified due to missing information. Approach 2 classified 19.6% as aggressive and 29% were unclassified. Sensitivity was highest for Approach 1 (0.76, 95% CI: 0.72 - 0.80 vs 0.69, 95% CI: 0.64 - 0.73), while PPVs were similar for both approaches (0.43, 95% CI: 0.40 - 0.46 and 0.40, 95% CI: 0.36 - 0.44). We observed similarly high sensitivity and higher PPVs than those reported by the PC3 Working Group. CONCLUSIONS: The proposed definition of aggressive PC was applicable and valid in the JSB cohort. Stage at diagnosis can be useful if data on cTNM or Gleason score is unavailable.
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Neoplasias da Próstata , Masculino , Humanos , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/epidemiologia , Próstata/patologia , Antígeno Prostático Específico , Gradação de Tumores , Sistema de RegistrosRESUMO
The intermetallic compound Eu[Formula: see text]In[Formula: see text]Sb[Formula: see text], an antiferromagnetic material with nonsymmorphic crystalline structure, is investigated by magnetic, electronic transport and specific heat measurements. Being a Zintl phase, insulating behavior is expected. Our thermodynamic and magnetotransport measurements along different crystallographic directions strongly indicate polaron formation well above the magnetic ordering temperatures. Pronounced anisotropies of the magnetic and transport properties even above the magnetic ordering temperature are observed despite the Eu[Formula: see text] configuration which testify to complex and competing magnetic interactions between these ions and give rise to intricate phase diagrams discussed in detail. Our results provide a comprehensive framework for further detailed study of this multifaceted compound with possible nontrivial topology.
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The lower limb is a common site for melanoma in women, but the reason for this is not fully understood. To investigate this phenomenon in more detail, we assessed the specific subsites of primary melanoma occurring on the lower limbs of females compared with males across age groups. In a records-based study at an oncology hospital in north-west of England, among an unselected sample of patients with primary invasive melanoma treated between 2002-2015, information was collected on patient age at diagnosis, sex, and co-morbidities, and the tumor thickness and anatomical subsite (thigh, lower leg, foot for lower limb). Of a total sample of 1,522 patients, 316 (227, 72% female) had lower limb melanoma. The most common subsite was lower leg (142 cases with F:M ratio =3.74), followed by thigh (55 cases with F:M = 1.83) and feet (30 cases with F:M = 1.15). At ages <40 years the odds of thigh to foot melanoma was 20 times higher in females than in males (OR 20.0, 95% CI 2.6-152.6) and 7.5 times higher on the lower limb (OR 7.5, 95% CI 1.1-49.2). For ages 40+ years, the odds of females developing thigh melanoma compared to foot melanoma was similar in males versus females (OR 0.8), while the corresponding odds of lower leg melanoma in females versus males remained significantly increased at ages 40-59 and 60+ (OR 4.2 and 2.8 respectively). Our study demonstrates the female predilection for lower limb melanoma persists over most but not all subsites.However, there is heterogeneity in the female to male occurence of lower limb melanoma across subsites and at different ages, which may be linked to relative influence of genetic and environmental risk factors.
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Melanoma , Neoplasias Cutâneas , Humanos , Feminino , Masculino , Adulto , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/patologia , Melanoma/epidemiologia , Melanoma/patologia , Extremidade Inferior/patologiaRESUMO
Haemophagocytic lymphohistiocytosis (HLH) is a rare condition resulting from a dysregulated inflammatory response. Currently there are no guidelines on the reporting of haemophagocytosis on bone marrow biopsy (BM) and lack of evidence on correlation between haemophagocytosis with the clinical diagnostic criteria for HLH. We aimed to assess if the amount of haemophagocytosis identified in the BM correlates with HLH-2004 criteria. Secondary aims were to evaluate inter-observer variability in reporting haemophagocytosis, and to formulate recommendations for screening in bone marrow specimens. A retrospective review of bone marrow biopsies from adult patients under investigation for HLH was undertaken independently by two haematopathologists who were blinded to the original biopsy report. The average number of actively haemophagocytic cells in each slide were quantified. Cases with discordance pertaining to the degree of haemophagocytosis were reviewed by both assessors to reach a consensus. Sixty-two specimens from 59 patients were available for assessment. An underlying haematological condition was identified in 34 cases (58%). There was a significant association between the amount of haemophagocytosis identified on the aspirate samples and the number of HLH-2004 criteria met (p<0.0001). In patients where haemophagocytosis was present (n=31), there was a correlation between the amount of haemophagocytosis and ferritin (p=0.041). Based on our review, we have made recommendations for the reporting of BM haemophagocytosis. Our findings indicate that the amount of haemophagocytosis present on BM samples correlates with the number of HLH-2004 criteria. We found marked interobserver variability which we anticipate can be rectified with our recommendations for reporting.
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Linfo-Histiocitose Hemofagocítica , Adulto , Biópsia , Medula Óssea/patologia , Ferritinas , Humanos , Linfo-Histiocitose Hemofagocítica/diagnóstico , Linfo-Histiocitose Hemofagocítica/patologia , Baço/patologiaRESUMO
Skin volatile organic compounds (VOCs) can cause body odor or reveal human disease and may result from lipid peroxidation or activity by skin bacteria. We examined the effect of intake of New Zealand blackcurrant (NZBC) powder for 77 skin VOCs in middle-aged and older adults in a crossover design. Fourteen adults (nine males, age: 55 ± 5 yrs) consumed NZBC powder for 7 days (6 g·day-1 with 138.6 mg anthocyanins). Two hours after the last intake, a passive flux sampler with trapping media was applied in the base of the neck for 1 hour. Gas chromatography-mass spectrometry was used for media analysis. Habitual anthocyanin intake was quantified using a food frequency questionnaire. Compared to control (i.e., no intake of NZBC powder), emission of six skin VOCs (i.e., 2-nonenal, acetic acid, 2-hexanone, 6-methyl-5-hepten-2-one, benzaldehyde, allyl methyl sulfide) were lower by more than 25%. Increases were observed for γ-octanolactone (+184%) and γ-decanolactone (+89%). A trend for a decrease for isovaleraldehyde, hexanal, and 2-pentanone, and an increase for heptanoic acid and γ-nonanolactone was observed. There was a significant correlation with daily habitual dietary anthocyanin intake for control values of hexanal and percentage change of γ-octanolactone. NZBC powder can change emanation of some VOCs in human skin. Analysis of skin VOCs following specific polyphenol intake may address the impact of dietary components to affect internal metabolic processes, body odor, and health.
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Ribes , Compostos Orgânicos Voláteis , Idoso , Antocianinas , Estudos Cross-Over , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nova Zelândia , Pós , Ribes/química , Compostos Orgânicos Voláteis/metabolismoRESUMO
BACKGROUND: Price-based policies are effective alcohol harm minimisation policy options. This paper examines public support for price-based policies based on patterns of consumption and expenditure, to determine if the extent to which an individual may be affected by a policy influences their support. METHODS: The current study included 1,684 Australian residents (59.8% male, Mage 43.8 [SD=16.7]). Respondents who purchased and consumed alcohol in the past six months were asked about their support for potential changes in a series of price-based policies. RESULTS: Increasing price was less likely to be supported than either implementing a minimum price or a tax-increase earmarked to pay for alcohol harms. Increasing price and taxing drinkers were more likely to be supported by older people and women. We found no relationship between income or perceived impact of price increases on purchasing and level of support. CONCLUSION: Contrary to the idea that public support might be partly influenced by ability to pay for alcohol, support for a minimum unit price was not related to price paid per drink or income, only amount consumed. Thus, heavier drinkers may be inherently unlikely to support price-based policies even when these policies would have little impact on their actual purchasing.
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Consumo de Bebidas Alcoólicas , Bebidas Alcoólicas , Adulto , Idoso , Consumo de Bebidas Alcoólicas/epidemiologia , Austrália , Comércio , Feminino , Humanos , Masculino , Política PúblicaRESUMO
Greater densities of alcohol outlets are associated with greater incidence of alcohol-related harms. In Australia, public health advocates aiming to limit alcohol availability expend significant energy objecting to new outlets in licensing and planning hearings. This study identifies and reviews the key scientific arguments put forward by industry and public health representatives in liquor and planning hearings to determine the factors that contribute to decisions by the presiding authority and to identify ways forward for researchers wishing to facilitate harm minimisation through these regulatory forums. Scientific evidence presented in 23 cases from Victoria, New South Wales and Western Australia between 2010 and 2018 were assessed using directed content analysis. Cases were identified through the AustLii and Westlaw online databases. The full transcripts of two cases that were identified as representative of the scientific arguments presented in other included cases were also reviewed. Four main arguments that industry used during hearings were identified-causal inference, non-linearities, differentiation and risk mitigation. These arguments were used across many included hearings and raised fundamental questions that public health evidence was often ill-equipped to respond to. The overall success of industry arguments in liquor and planning hearings highlighted the challenges of applying epidemiological evidence to individual case studies. These findings have particular implications and will be of use for researchers and public health experts participating in future licensing hearings, especially those wishing to prevent alcohol-related harm through regulatory mechanisms such as state licensing authorities (i.e. courts).
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Consumo de Bebidas Alcoólicas , Saúde Pública , Bebidas Alcoólicas , Humanos , New South Wales , Vitória , Austrália OcidentalRESUMO
BACKGROUND: Advanced prostate cancer etiology is poorly understood. Few studies have examined associations of anthropometric factors (e.g. early adulthood obesity) with advanced prostate cancer risk. PATIENTS AND METHODS: We carried out pooled analyses to examine associations between body fatness, height, and prostate cancer risk. Among 830 772 men, 51 734 incident prostate cancer cases were identified, including 4762 advanced (T4/N1/M1 or prostate cancer deaths) cases, 2915 advanced restricted (same as advanced, but excluding localized cancers that resulted in death) cases, 9489 high-grade cases, and 3027 prostate cancer deaths. Cox proportional hazards models were used to calculate study-specific hazard ratios (HR) and 95% confidence intervals (CI); results were pooled using random effects models. RESULTS: No statistically significant associations were observed for body mass index (BMI) in early adulthood for advanced, advanced restricted, and high-grade prostate cancer, and prostate cancer mortality. Positive associations were shown for BMI at baseline with advanced prostate cancer (HR = 1.30, 95% CI = 0.95-1.78) and prostate cancer mortality (HR = 1.52, 95% CI = 1.12-2.07) comparing BMI ≥35.0 kg/m2 with 21-22.9 kg/m2. When considering early adulthood and baseline BMI together, a 27% higher prostate cancer mortality risk (95% CI = 9% to 49%) was observed for men with BMI <25.0 kg/m2 in early adulthood and BMI ≥30.0 kg/m2 at baseline compared with BMI <25.0 kg/m2 in early adulthood and BMI <30.0 kg/m2 at baseline. Baseline waist circumference, comparing ≥110 cm with <90 cm, and waist-to-hip ratio, comparing ≥1.00 with <0.90, were associated with significant 14%-16% increases in high-grade prostate cancer risk and suggestive or significant 20%-39% increases in prostate cancer mortality risk. Height was associated with suggestive or significant 33%-56% risks of advanced or advanced restricted prostate cancer and prostate cancer mortality, comparing ≥1.90 m with <1.65 m. CONCLUSION: Our findings suggest that height and total and central adiposity in mid-to-later adulthood, but not early adulthood adiposity, are associated with risk of advanced forms of prostate cancer. Thus, maintenance of healthy weight may help prevent advanced prostate cancer.
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Neoplasias da Próstata , Adulto , Estatura , Índice de Massa Corporal , Dieta , Humanos , Masculino , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Circunferência da CinturaRESUMO
Sentinel node biopsy (SNB) has been at the forefront of the surgical staging of melanoma patients for the past 15 years. The high accuracy of this prognostic staging procedure is now recognised in all international guidelines for melanoma. However during this period there have been a number of important changes in the management of melanoma, many occurring within the past five years. The outcomes of five recent randomised Phase 3 trials have established the role of adjuvant targeted therapy and immunotherapy in resected Stage 3 and Stage 4 disease and have potentially changed the role of SNB. Two landmark international prospective studies have examined the benefit of performing a completion lymph node dissection (CLND) following the detection of microscopicallyinvolved sentinel nodes. Finally, the marked increase in the incidence of melanoma and the role of SNB in potentially guiding therapy has resulted in a significant increase in the pathological workload of the dermatopathology services. To address these issues a multi-disciplinary consensus meeting involving many melanoma experts from the UK was convened in May 2018. Three main areas were considered: oncology, surgery and pathology. This report is a summary of the conclusions reached, which were agreed by the clinicians attending the meeting and then externally peer reviewed. The recommendations summarised in this Consensus Statement.
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Melanoma/patologia , Biópsia de Linfonodo Sentinela , Neoplasias Cutâneas/patologia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Quimioterapia Adjuvante , Ensaios Clínicos como Assunto , Diagnóstico por Imagem , Humanos , Excisão de Linfonodo/métodos , Excisão de Linfonodo/mortalidade , Melanoma/tratamento farmacológico , Melanoma/mortalidade , Prognóstico , Fatores de Risco , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/mortalidade , Reino UnidoRESUMO
The objective of this study was to identify, understand and generate a Taguchi orthogonal array model for the formation of 10-50 µm microparticles with applications in topical/ocular controlled drug delivery. Poly(lactic-co-glycolic acid) (PLGA) microparticles were fabricated by the single emulsion oil-in-water method and the particle size was characterized using laser diffraction and scanning electronic microscopy (SEM). Sequential Taguchi L12 and L18 orthogonal array (OA) designs were employed to study the influence of ten and eight parameters, respectively, on microparticle size (response). The first optimization step using the L12 design showed that all parameters significantly influenced the particle size of the prepared PLGA microparticles with exception of the concentration of poly(vinyl alcohol) (PVA) in the hardening bath. The smallest mean particle size obtained from the L12 design was 54.39 µm. A subsequent L18 design showed that the molecular weight of PLGA does not significantly affect the particle size. An experimental run comprising of defined parameters including molecular weight of PLGA (89 kDa), concentration of PLGA (20% w/v), concentration of PVA in the emulsion (0.8% w/v), solvent type (ethyl acetate), organic/aqeuous phase ratio (1:1 v/v), vortexing speed (9), vortexing duration (60 seconds), concentration of PVA in hardening bath (0.8% w/v), stirring speed of hardening bath (1200 rpm) and solvent evaporation duration (24 hours) resulted in the lowest mean particle size of 23.51 µm which was predicted and confirmed by the L18 array. A comparable size was demonstrated during the fabrication of BSA-incorporated microparticles. Taguchi OA design proved to be a valuable tool in determining the combination of process parameters that can provide the optimal condition for microparticle formulation. Taguchi OA design can be used to correctly predict the size of microparticles fabricated by the single emulsion process and can therefore, ultimately, save time and costs during the manufacturing process of drug delivery formulations by minimising experimental runs.
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Química Farmacêutica/métodos , Portadores de Fármacos/química , Composição de Medicamentos/métodos , Microesferas , Copolímero de Ácido Poliláctico e Ácido Poliglicólico/química , Tamanho da Partícula , Álcool de Polivinil/química , Solventes/químicaRESUMO
Yellow and orange egg yolks are good sources of xanthophyll carotenoids, consumption of which is associated with health benefits, such as cancer prevention, eye health, and bone health. Industrial feed fortificants used to improve egg yolk color and carotenoid concentration typically are derived from marigold flowers. Green leafy vegetables are also concentrated sources of the xanthophylls lutein and zeaxanthin (L+Z), but they have not been rigorously evaluated in laying hen feeds as a yolk colorant. The addition of food manufacturing byproducts, including carrot leaves, to animal feed is a promoted method of improving animal nutrition. The ability of dehydrated carrot leaves to improve egg yolk color and L+Z concentration was evaluated by feeding laying hens (n = 40) white maize-based feeds fortified with 2 different dehydrated carrot leaves, marigold as a positive control, or no fortificant as a negative control for 28 D. After a 7-D washout period, the hens were separated into 4 groups, and eggs were collected every other day. Yolks were analyzed by using a portable colorimeter to define the color space and by ultra-performance liquid chromatography to determine the carotenoid profile. Carotenoid concentration rapidly declined from day 0 to 8, confirming adequate washout conditions. The white maize negative control (WM) day 28 lutein concentration (3.59 ± 0.51 nmol/g) was significantly less than orange-carrot leaf-treated (OCL) (5.34 ± 0.36 nmol/g) and red-carrot leaf-treated hens (RCL) (5.92 ± 1.00 nmol/g) in addition to the marigold-treated hens (MG). However, MG was significantly higher than both leaf-treated groups. From day 8 (3.93 ± 0.74 nmol/g) to 28 (9.32 ± 1.66 nmol/g), MG had the largest increase in lutein and was the only treatment to surpass day 0 initial concentrations (8.50 ± 1.64 nmol/g). A similar trend was observed for zeaxanthin and was reflected in the color space.
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Cor , Daucus carota/química , Gema de Ovo/química , Ovos/análise , Alimentos Fortificados/análise , Tagetes/química , Xantofilas/análise , Animais , Galinhas , Feminino , Folhas de Planta/químicaRESUMO
BACKGROUND/AIM: Disease related malnutrition is a major problem in hospitals. Malnutrition in hospitalized patients is caused by many factors. Among these factors are decreased appetite and early satiety, and reaching nutritional requirements in nutritional risk patients is a challenge when using ordinary energy and protein dense food. The aim of this study was to examine if total protein and energy intake in medical and surgical patients at nutritional risk could be improved by protein fortified and energy rich in-between meals. METHODS: An assortment of fortified in-between meals including 10 g of protein was developed based on patient preferences and served in the Departments of Lung Medicine and Abdominal Surgery for a period of three months. Nutrition intake was recorded before and after intervention. RESULTS: Food intake records were collected from a total of 92 patients, (46 before and 46 after intervention). The total amount of protein intake per in-between meal was increased from 2,6 g to 10,3 g. Total daily protein intake increased from 49% to 88% (p < 0.00) and total energy intake from 74% to 109% (p < 0.00) of requirements. CONCLUSION: Protein and energy intake for surgical and medical patients at in-between meals as well as total daily intake increased significantly. Recommended average level for individually measured requirements was reached.
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Proteínas Alimentares , Ingestão de Energia , Pacientes Internados , Refeições , Desnutrição Proteico-Calórica/prevenção & controle , Feminino , Serviço Hospitalar de Nutrição , Humanos , Masculino , Necessidades Nutricionais , Estado Nutricional , Resultado do TratamentoRESUMO
While new generations of implantable brain computer interface (BCI) devices are being developed, evidence in the literature about their impact on the patient experience is lagging. In this article, we address this knowledge gap by analysing data from the first-in-human clinical trial to study patients with implanted BCI advisory devices. We explored perceptions of self-change across six patients who volunteered to be implanted with artificially intelligent BCI devices. We used qualitative methodological tools grounded in phenomenology to conduct in-depth, semi-structured interviews. Results show that, on the one hand, BCIs can positively increase a sense of the self and control; on the other hand, they can induce radical distress, feelings of loss of control, and a rupture of patient identity. We conclude by offering suggestions for the proactive creation of preparedness protocols specific to intelligent-predictive and advisory-BCI technologies essential to prevent potential iatrogenic harms.
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Inteligência Artificial , Interfaces Cérebro-Computador/efeitos adversos , Próteses e Implantes/efeitos adversos , Autoimagem , Estresse Psicológico/etiologia , Tecnologia , Encéfalo , Humanos , Inteligência , Conhecimento , Pesquisa Qualitativa , Inquéritos e QuestionáriosRESUMO
Preliminary evidence suggests that sex steroid hormones, such as danazol (a synthetic sex steroid hormone), may be involved in enhancing telomerase activity. Elucidating underlying mechanisms of telomerase activity may further therapeutic options for individuals with telomeropathies and potentially avert certain age-related conditions. Therefore, we conducted a cross-sectional study to investigate the relationship between circulating sex steroid hormones and SHBG with leukocyte telomere length among 499 males in NHANES (1999-2002 surveys). Sample-weighted linear regression analyses were conducted to assess age-adjusted and multivariable-adjusted estimates of associations. Estimates were rescaled to represent telomere length change in base pairs per half the value of the interquartile range of the independent variable. Estradiol and free estradiol were significantly inversely associated with leukocyte telomere length (ßcontinuous per §IQR = -61, p = 0.04; free estradiol ßcontinuous per §IQR = -67, p = 0.03). Testosterone, free testosterone, androstanediol glucuronide, and SHBG were not associated with leukocyte telomere length. The inverse association seen in this study indicates that a danazol-induced hypoestrogenic state could partly underlie the previously observed association between danazol therapy and increased leukocyte telomere length.
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Hormônios Esteroides Gonadais/sangue , Homeostase do Telômero/fisiologia , Telômero/metabolismo , Adulto , Idoso , Estudos Transversais , Humanos , Leucócitos/metabolismo , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Globulina de Ligação a Hormônio Sexual/metabolismoRESUMO
The primary objective of this randomized controlled trial was to determine whether anti-IL-10 egg yolk antibodies fed upon arrival to a calf ranch would lower the prevalence of Cryptosporidium parvum shedding in naturally challenged preweaned dairy calves. The secondary objectives included measuring the effect of anti-IL-10 antibodies on calf health, performance, and shedding of less common diarrheal pathogens. A total of 133 calves, enrolled at 24 to 72 h of age, received a daily dose of 0.96 g of egg yolk powder with anti-IL-10 antibodies (MAB, n = 71) or without anti-IL-10 antibodies (MEP, n = 62) split between 2 feedings for the first 11 d on feed at a calf ranch. Daily health evaluations were completed for 15 d after arrival and on d 56. Digital weights were collected at enrollment and d 56, and hipometer weights were collected at enrollment and d 7 and 56. Packed cell volume and serum total protein concentration were measured at enrollment and on d 7 and 14. Fecal pH was measured at enrollment and on d 5 and 14, and fecal pathogen (C. parvum, coronavirus, rotavirus, and Salmonella spp.) shedding was assessed at d 5 and 14. Continuous outcomes were compared between groups using a Student's t-test or Wilcoxon rank sum test. Fecal pathogen shedding at d 14, respiratory disease at d 56, and antibiotic usage were compared using relative risk (RR) and chi-squared test. Fecal pH (median and interquartile range) on d 14 was 6.65 (6.39-6.99) and 6.52 (5.97-6.81) for MAB and MEP, respectively. On d 56, the risk of respiratory disease was lower for MAB compared with MEP (RR = 0.40; confidence interval = 0.16-0.99). The risk for antibiotic treatment was lower for MAB- compared with MEP-treated calves (RR = 0.38; confidence interval = 0.17-0.88). The risk of shedding rotavirus was higher in MAB (RR = 1.38; confidence interval = 1.10-1.81) calves. After multivariable analyses, hipometer weights (least squares means ± standard error) were 1.7 ± 0.8 kg greater on d 56 in MAB compared with MEP; however, ADG was 0.04 ± 0.02 kg/d lower in MAB calves. Total health score, diarrhea days, average respiratory score, packed cell volume, and serum total protein were not affected by feeding anti-IL-10 egg antibodies. In summary, feeding anti-IL-10 antibodies was associated with increased fecal pH, reduced risk of respiratory disease later in the preweaning period, and decreased antibiotic usage despite higher rotavirus infection. These findings might be associated with improved mucosal immunity, enhanced host defenses, or reduced susceptibility and warrant further investigation.