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1.
Biol Lett ; 17(6): 20210097, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34129795

RESUMO

In a fast-changing world, polar ecosystems are threatened by climate variability. Understanding the roles of fine-scale processes, and linear and nonlinear effects of climate factors on the demography of polar species is crucial for anticipating the future state of these fragile ecosystems. While the effects of sea ice on polar marine top predators are increasingly being studied, little is known about the impacts of landfast ice (LFI) on this species community. Based on a unique 39-year time series of satellite imagery and in situ meteorological conditions and on the world's longest dataset of emperor penguin (Aptenodytes forsteri) breeding parameters, we studied the effects of fine-scale variability of LFI and weather conditions on this species' reproductive success. We found that longer distances to the LFI edge (i.e. foraging areas) negatively affected the overall breeding success but also the fledging success. Climate window analyses suggested that chick mortality was particularly sensitive to LFI variability between August and November. Snowfall in May also affected hatching success. Given the sensitivity of LFI to storms and changes in wind direction, important future repercussions on the breeding habitat of emperor penguins are to be expected in the context of climate change.


Assuntos
Ecossistema , Spheniscidae , Animais , Regiões Antárticas , Mudança Climática , Camada de Gelo , Reprodução
2.
J Anim Ecol ; 89(1): 104-119, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31368149

RESUMO

Ecological niche theory predicts sympatric species to show segregation in their spatio-temporal habitat utilization or diet as a strategy to avoid competition. Similarly, within species individuals may specialize on specific dietary resources or foraging habitats. Such individual specialization seems to occur particularly in environments with predictable resource distribution and limited environmental variability. Still, little is known about how seasonal environmental variability affects segregation of resources within species and between closely related sympatric species. The aim of the study was to investigate the foraging behaviour of three closely related and sympatrically breeding fulmarine petrels (Antarctic petrels Thalassoica antarctica, cape petrels Daption capense and southern fulmars Fulmarus glacialoides) in a seasonally highly variable environment (Prydz Bay, Antarctica) with the aim of assessing inter- and intraspecific overlap in utilized habitat, timing of foraging and diet and to identify foraging habitat preferences. We used GPS loggers with wet/dry sensors to assess spatial habitat utilization over the entire breeding season. Trophic overlap was investigated using stable isotope analysis based on blood, feathers and egg membranes. Foraging locations were identified using wet/dry data recorded by the GPS loggers and expectation-maximization binary clustering. Foraging habitat preferences were modelled using generalized additive models and model cross-validation. During incubation and chick-rearing, the utilization distribution of all three species overlapped significantly and species also overlapped in the timing of foraging during the day-partly during incubation and completely during chick-rearing. Isotopic centroids showed no significant segregation between at least two species for feathers and egg membranes, and among all species during incubation (reflected by blood). Within species, there was no individual specialization in foraging sites or environmental space. Furthermore, no single environmental covariate predicted foraging activity along trip trajectories. Instead, best-explanatory environmental covariates varied within and between individuals even across short temporal scales, reflecting a highly generalist behaviour of birds. Our results may be explained by optimal foraging theory. In the highly productive but spatio-temporally variable Antarctic environment, being a generalist may be key to finding mobile prey-even though this increases the potential for competition within and among sympatric species.


Assuntos
Aves , Ecossistema , Animais , Regiões Antárticas , Cruzamento , Plumas , Comportamento Alimentar
3.
J Anim Ecol ; 89(1): 221-236, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31190329

RESUMO

Light-level geolocator tags use ambient light recordings to estimate the whereabouts of an individual over the time it carried the device. Over the past decade, these tags have emerged as an important tool and have been used extensively for tracking animal migrations, most commonly small birds. Analysing geolocator data can be daunting to new and experienced scientists alike. Over the past decades, several methods with fundamental differences in the analytical approach have been developed to cope with the various caveats and the often complicated data. Here, we explain the concepts behind the analyses of geolocator data and provide a practical guide for the common steps encompassing most analyses - annotation of twilights, calibration, estimating and refining locations, and extraction of movement patterns - describing good practices and common pitfalls for each step. We discuss criteria for deciding whether or not geolocators can answer proposed research questions, provide guidance in choosing an appropriate analysis method and introduce key features of the newest open-source analysis tools. We provide advice for how to interpret and report results, highlighting parameters that should be reported in publications and included in data archiving. Finally, we introduce a comprehensive supplementary online manual that applies the concepts to several datasets, demonstrates the use of open-source analysis tools with step-by-step instructions and code and details our recommendations for interpreting, reporting and archiving.


Assuntos
Migração Animal , Aves , Animais
4.
Glob Chang Biol ; 24(11): 5304-5317, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-29957836

RESUMO

The Southern Ocean is currently experiencing major environmental changes, including in sea-ice cover. Such changes strongly influence ecosystem structure and functioning and affect the survival and reproduction of predators such as seabirds. These effects are likely mediated by reduced availability of food resources. As such, seabirds are reliable eco-indicators of environmental conditions in the Antarctic region. Here, based on 9 years of sea-ice data, we found that the breeding success of Adélie penguins (Pygoscelis adeliae) reaches a peak at intermediate sea-ice cover (ca. 20%). We further examined the effects of sea-ice conditions on the foraging activity of penguins, measured at multiple scales from individual dives to foraging trips. Analysis of temporal organisation of dives, including fractal and bout analyses, revealed an increasingly consistent behaviour during years with extensive sea-ice cover. The relationship between several dive parameters and sea-ice cover in the foraging area appears to be quadratic. In years of low and high sea-ice cover, individuals adjusted their diving effort by generally diving deeper, more frequently and by resting at the surface between dives for shorter periods of time than in years with intermediate sea-ice cover. Our study therefore suggests that sea-ice cover is likely to affect the reproductive performance of Adélie penguins through its effects on foraging behaviour, as breeding success and most diving parameters share a common optimum. Some years, however, deviated from this general trend, suggesting that other factors (e.g. precipitation during the breeding season) might sometimes become preponderant over the sea-ice effects on breeding and foraging performance. Our study highlights the value of monitoring fitness parameters and individual behaviour concomitantly over the long-term to better characterize optimal environmental conditions and potential resilience of wildlife. Such an approach is crucial if we want to anticipate the effects of environmental change on Antarctic penguin populations.


Assuntos
Mergulho , Camada de Gelo , Reprodução , Spheniscidae/fisiologia , Animais , Regiões Antárticas , Ecossistema , Estações do Ano
5.
Glob Chang Biol ; 23(12): 5136-5150, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-28590592

RESUMO

Understanding divergent biological responses to climate change is important for predicting ecosystem level consequences. We use species habitat models to predict the winter foraging habitats of female southern elephant seals and investigate how changes in environmental variables within these habitats may be related to observed decreases in the Macquarie Island population. There were three main groups of seals that specialized in different ocean realms (the sub-Antarctic, the Ross Sea and the Victoria Land Coast). The physical and climate attributes (e.g. wind strength, sea surface height, ocean current strength) varied amongst the realms and also displayed different temporal trends over the last two to four decades. Most notably, sea ice extent increased on average in the Victoria Land realm while it decreased overall in the Ross Sea realm. Using a species distribution model relating mean residence times (time spent in each 50 × 50 km grid cell) to 9 climate and physical co-variates, we developed spatial predictions of residence time to identify the core regions used by the seals across the Southern Ocean from 120°E to 120°W. Population size at Macquarie Island was negatively correlated with ice concentration within the core habitat of seals using the Victoria Land Coast and the Ross Sea. Sea ice extent and concentration is predicted to continue to change in the Southern Ocean, having unknown consequences for the biota of the region. The proportion of Macquarie Island females (40%) utilizing the relatively stable sub-Antarctic region, may buffer this population against longer-term regional changes in habitat quality, but the Macquarie Island population has persistently decreased (-1.45% per annum) over seven decades indicating that environmental changes in the Antarctic are acting on the remaining 60% of the population to impose a long-term population decline in a top Southern Ocean predator.


Assuntos
Mudança Climática , Camada de Gelo , Focas Verdadeiras , Distribuição Animal , Animais , Regiões Antárticas , Ecossistema , Feminino , Dinâmica Populacional , Estações do Ano , Vento
7.
Glob Chang Biol ; 20(10): 3004-25, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24802817

RESUMO

Antarctic and Southern Ocean (ASO) marine ecosystems have been changing for at least the last 30 years, including in response to increasing ocean temperatures and changes in the extent and seasonality of sea ice; the magnitude and direction of these changes differ between regions around Antarctica that could see populations of the same species changing differently in different regions. This article reviews current and expected changes in ASO physical habitats in response to climate change. It then reviews how these changes may impact the autecology of marine biota of this polar region: microbes, zooplankton, salps, Antarctic krill, fish, cephalopods, marine mammals, seabirds, and benthos. The general prognosis for ASO marine habitats is for an overall warming and freshening, strengthening of westerly winds, with a potential pole-ward movement of those winds and the frontal systems, and an increase in ocean eddy activity. Many habitat parameters will have regionally specific changes, particularly relating to sea ice characteristics and seasonal dynamics. Lower trophic levels are expected to move south as the ocean conditions in which they are currently found move pole-ward. For Antarctic krill and finfish, the latitudinal breadth of their range will depend on their tolerance of warming oceans and changes to productivity. Ocean acidification is a concern not only for calcifying organisms but also for crustaceans such as Antarctic krill; it is also likely to be the most important change in benthic habitats over the coming century. For marine mammals and birds, the expected changes primarily relate to their flexibility in moving to alternative locations for food and the energetic cost of longer or more complex foraging trips for those that are bound to breeding colonies. Few species are sufficiently well studied to make comprehensive species-specific vulnerability assessments possible. Priorities for future work are discussed.


Assuntos
Organismos Aquáticos , Mudança Climática , Camada de Gelo , Regiões Antárticas , Biota , Ecossistema , Oceanos e Mares , Movimentos da Água , Vento
8.
J Anim Ecol ; 82(1): 72-83, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22881702

RESUMO

Many optimal foraging models for diving animals examine strategies that maximize time spent in the foraging zone, assuming that prey acquisition increases linearly with search time. Other models have considered the effect of patch quality and predict a net energetic benefit if dives where no prey is encountered early in the dive are abandoned. For deep divers, however, the energetic benefit of giving up is reduced owing to the elevated energy costs associated with descending to physiologically hostile depths, so patch residence time should be invariant. Others consider an asymptotic gain function where the decision to leave a patch is driven by patch-depletion effects - the marginal value theorem. As predator behaviour is increasingly being used as an index of marine resource density and distribution, it is important to understand the nature of this gain function. We investigated the dive behaviour of the world's deepest-diving seal, the southern elephant seal Mirounga leonina, in response to patch quality. Testing these models has largely been limited to controlled experiments on captive animals. By integrating in situ measurements of the seal's relative lipid content obtained from drift rate data (a measure of foraging success) with area-restricted search behaviour identified from first-passage time analysis, we identified regions of high- and low-quality patches. Dive durations and bottom times were not invariant and did not increase in regions of high quality; rather, both were longer when patches were of relatively low quality. This is consistent with the predictions of the marginal value theorem and provides support for a nonlinear relationship between search time and prey acquisition. We also found higher descent and ascent rates in high-quality patches suggesting that seals minimized travel time to the foraging patch when quality was high; however, this was not achieved by increasing speed or dive angle. Relative body lipid content was an important predictor of dive behaviour. Seals did not schedule their diving to maximize time spent in the foraging zone in higher-quality patches, challenging the widely held view that maximizing time in the foraging zone translates to greater foraging success.


Assuntos
Mergulho , Ecossistema , Comportamento Alimentar/fisiologia , Oceanos e Mares , Focas Verdadeiras/fisiologia , Animais , Regiões Antárticas , Metabolismo dos Lipídeos
9.
Int Wound J ; 10(2): 132-7, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23506344

RESUMO

This was an open-label, prospective, multicentre, randomised controlled study to evaluate the efficacy and safety of human fibroblast-derived dermal substitute (HFDS) plus four-layer compression therapy compared with compression therapy alone in the treatment of venous leg ulcers. The primary outcome variable was the proportion of patients with completely healed study ulcers by 12 weeks. The number healed was further summarised by ulcer duration and baseline ulcer size. Sixty-four (34%) of 186 patients in the HFDS group experienced healing by week 12 compared with 56 (31%) of 180 patients in the control group (P = 0·235). For ulcers ≤ 12 months duration, 49 (52%) of 94 patients in the HFDS group versus 36 (37%) of 97 patients in the control group healed at 12 weeks (P = 0·029). For ulcers ≤ 10 cm(2), complete healing at week 12 was observed in 55 (47%) of 117 patients in the HFDS group compared with 47 (39%) of 120 patients in the control group (P = 0·223). The most common adverse events (AEs) were wound infection, cellulitis and skin ulcer. The frequency of AEs did not markedly differ between the treatment and control groups.


Assuntos
Materiais Revestidos Biocompatíveis/uso terapêutico , Transplante de Pele/métodos , Pele Artificial , Úlcera Varicosa/terapia , Idoso , Canadá , Feminino , Fibroblastos/citologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Resultado do Tratamento , Reino Unido , Estados Unidos , Cicatrização
10.
Sci Adv ; 9(39): eadg8340, 2023 09 29.
Artigo em Inglês | MEDLINE | ID: mdl-37756400

RESUMO

Predicting species survival in the face of climate change requires understanding the drivers that influence their distribution. Emperor penguins (Aptenodytes forsteri) incubate and rear chicks on landfast sea ice, whose extent, dynamics, and quality are expected to vary substantially due to climate change. Until recently, this species' continent-wide observations were scarce, and knowledge on their distribution and habitat limited. Advances in satellite imagery now allow their observation and characterization of habitats across Antarctica at high resolution. Using circumpolar high-resolution satellite images, unique fast ice metrics, and geographic and biological factors, we identified diverse penguin habitats across the continent, with no significant difference between areas with penguins or not. There is a clear geographic partitioning of colonies with respect to their defining habitat characteristics, indicating possible behavioral plasticity among different metapopulations. This coincides with geographic structures found in previous genetic studies. Given projections of quasi-extinction for this species in 2100, this study provides essential information for conservation measures.


Assuntos
Camada de Gelo , Spheniscidae , Animais , Regiões Antárticas , Galinhas , Mudança Climática
11.
Artigo em Inglês | MEDLINE | ID: mdl-34127448

RESUMO

The nuclear pore complex (NPC) is a highly conserved channel in the nuclear envelope that mediates mRNA export to the cytosol and bidirectional protein transport. Many chromosomal loci physically interact with nuclear pore proteins (Nups), and interactions with Nups can promote transcriptional repression, transcriptional activation, and transcriptional poising. Interaction with the NPC also affects the spatial arrangement of genes, interchromosomal clustering, and folding of topologically associated domains. Thus, the NPC is a spatial organizer of the genome and regulator of genome function.


Assuntos
Complexo de Proteínas Formadoras de Poros Nucleares , Poro Nuclear , Transporte Ativo do Núcleo Celular , Genoma , Poro Nuclear/genética , Poro Nuclear/metabolismo , Complexo de Proteínas Formadoras de Poros Nucleares/genética , Complexo de Proteínas Formadoras de Poros Nucleares/metabolismo , Transporte Proteico
12.
Dig Dis Sci ; 56(12): 3463-70, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21879279

RESUMO

BACKGROUND: Patients receiving 5-aminosalicylic acid (5-ASA) require long-term therapy to achieve good outcomes. Persistency (duration of time from initiation to discontinuation of therapy) is therefore an important consideration. AIM: To evaluate persistency in patients receiving various oral 5-ASA formulations. METHODS: This retrospective, 12-month, cohort study examined new-starter patients (any age and diagnosis) from a large United States pharmacy database who filled a prescription for oral 5-ASA [Lialda(®), Asacol(®), Pentasa(®) 250 or 500 mg, balsalazide (generic and Colazal(®)), and olsalazine (Dipentum(®))] between March and September 2007. Persistency was evaluated monthly on the basis of prescription refill rates. RESULTS: Prescription and refill records were identified for 44,191 patients receiving oral 5-ASA. After 1 year, 20% of patients receiving Lialda were considered persistent and classified as continuing (refilling within a timeframe of up to twice the duration of the prescription), compared with 9% receiving Asacol, 7 (250 mg) and 10% (500 mg) receiving Pentasa, 10% receiving balsalazide, and 10% receiving Dipentum. CONCLUSIONS: Overall persistency with oral 5-ASA therapy was low. However, patients receiving once-daily Lialda had significantly higher persistency after 1 year of treatment than patients receiving other oral 5-ASA therapies.


Assuntos
Colite Ulcerativa/tratamento farmacológico , Prescrições de Medicamentos/estatística & dados numéricos , Adesão à Medicação/estatística & dados numéricos , Mesalamina/administração & dosagem , Medicamentos sob Prescrição/administração & dosagem , Administração Oral , Adolescente , Adulto , Anti-Inflamatórios não Esteroides/administração & dosagem , Criança , Pré-Escolar , Colite Ulcerativa/epidemiologia , Relação Dose-Resposta a Droga , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
13.
Elife ; 102021 05 18.
Artigo em Inglês | MEDLINE | ID: mdl-34002694

RESUMO

Hundreds of genes interact with the yeast nuclear pore complex (NPC), localizing at the nuclear periphery and clustering with co-regulated genes. Dynamic tracking of peripheral genes shows that they cycle on and off the NPC and that interaction with the NPC slows their sub-diffusive movement. Furthermore, NPC-dependent inter-chromosomal clustering leads to coordinated movement of pairs of loci separated by hundreds of nanometers. We developed fractional Brownian motion simulations for chromosomal loci in the nucleoplasm and interacting with NPCs. These simulations predict the rate and nature of random sub-diffusion during repositioning from nucleoplasm to periphery and match measurements from two different experimental models, arguing that recruitment to the nuclear periphery is due to random sub-diffusion and transient capture by NPCs. Finally, the simulations do not lead to inter-chromosomal clustering or coordinated movement, suggesting that interaction with the NPC is necessary, but not sufficient, to cause clustering.


Assuntos
Cromatina/metabolismo , Poro Nuclear/metabolismo , Saccharomyces cerevisiae/metabolismo , Transporte Ativo do Núcleo Celular , Núcleo Celular , Cromatina/genética , Simulação por Computador , Poro Nuclear/genética , Saccharomyces cerevisiae/citologia , Saccharomyces cerevisiae/genética
14.
Front Neurol ; 10: 743, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31440197

RESUMO

Background: There is interest in the use geospatial data for development of acute stroke services given the importance of timely access to acute reperfusion therapy. This paper aims to introduce clinicians and citizen scientists to the possibilities offered by open source softwares (R and Python) for analyzing geospatial data. It is hoped that this introduction will stimulate interest in the field as well as generate ideas for improving stroke services. Method: Instructions on installation of libraries for R and Python, source codes and links to census data are provided in a notebook format to enhance experience with running the software. The code illustrates different aspects of using geospatial analysis: (1) creation of choropleth (thematic) map which depicts estimate of stroke cases per post codes; (2) use of map to help define service regions for rehabilitation after stroke. Results: Choropleth map showing estimate of stroke per post codes and service boundary map for rehabilitation after stroke. Conclusions The examples in this article illustrate the use of a range of components that underpin geospatial analysis. By providing an accessible introduction to these areas, clinicians and researchers can create code to answer clinically relevant questions on topics such as service delivery and service demand.

15.
Qual Manag Health Care ; 28(2): 84-95, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30801417

RESUMO

BACKGROUND: In an effort to reduce medication discrepancies during transitions of care and improve accuracy of the patient's medication list, AU Health conducted a study to identify a comprehensive set of issues related to electronic health record (EHR) medication reconciliation (MedRec) from the perspective of practitioners directly involved in the EHR MedRec process. METHODS: An exploratory mixed-method design was used. The 2-round study included 15 individual interviews, followed by a survey of 200 practitioners (ie, physicians, nurses, and pharmacists) based in the outpatient and inpatient medicine service at AU Health. RESULTS: Thematic analysis of interview data identified 55 issue items related to EHR MedRec under 9 issue categories. The survey sought practitioners' importance rating of all issue items identified from interviews. A total of 127 (63%) survey responses were received. Factor analysis served to validate the following 6 of the 9 issue categories, all of which were rated "important" or higher (on average), by over 70% of all respondents: (1) care coordination (CCI); (2) patient education (PEI); (3) ownership and accountability (OAI); (4) processes-of-care (PCI); (5) IT-related (ITRI); and (6) workforce training (WTI). Significance testing of importance rating by professional affiliation revealed no statistically significant differences for CCI and PEI, and some statistically significant differences for OAI, PCI, ITRI, and WTI. CONCLUSION: There were 2 key gleanings from the issues related to EHR MedRec unearthed by this study: (1) there was an absence of shared understanding among practitioners, of the value of EHR MedRec in promoting patient safety, which contributed to workarounds, and suboptimal use of the EHR MedRec system; and (2) there was a sociotechnical dimension to many of the issues, creating an added layer of complexity. These gleanings, in turn, provide insights into best practices for managing both (1) clinical transitions of care in the EHR MedRec process and (2) sociotechnical challenges encountered in EHR MedRec implementation.


Assuntos
Registros Eletrônicos de Saúde/organização & administração , Pessoal de Saúde/organização & administração , Pessoal de Saúde/psicologia , Reconciliação de Medicamentos/organização & administração , Fatores Etários , Continuidade da Assistência ao Paciente/organização & administração , Procedimentos Clínicos/normas , Registros Eletrônicos de Saúde/normas , Pessoal de Saúde/normas , Humanos , Entrevistas como Assunto , Erros de Medicação/prevenção & controle , Reconciliação de Medicamentos/normas , Educação de Pacientes como Assunto/organização & administração , Segurança do Paciente , Papel Profissional , Pesquisa Qualitativa , Fatores Sexuais , Interface Usuário-Computador
16.
J Am Diet Assoc ; 108(2): 347-56, 2008 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18237581

RESUMO

There is increasing evidence that dietary factors in plant-based diets are important in the prevention of chronic disease. This study examined protective (eg, antioxidant vitamins, carotenoids, and fiber) and pathogenic (eg, saturated fatty acids and cholesterol) dietary factors in a very-low-fat vegan diet. Ninety-three early-stage prostate cancer patients participated in a randomized controlled trial and were assigned to a very-low-fat (10% fat) vegan diet supplemented with soy protein and lifestyle changes or to usual care. Three-day food records were collected at baseline (n=42 intervention, n=43 control) and after 1 year (n=37 in each group). Analyses of changes in dietary intake of macronutrients, vitamins, minerals, carotenoids, and isoflavones from baseline to 1 year showed significantly increased intake of most protective dietary factors (eg, fiber increased from a mean of 31 to 59 g/day, lycopene increased from 8,693 to 34,464 mug/day) and significantly decreased intake of most pathogenic dietary factors (eg, saturated fatty acids decreased from 20 to 5 g/day, cholesterol decreased from 200 to 10 mg/day) in the intervention group compared to controls. These results suggest that a very-low-fat vegan diet can be useful in increasing intake of protective nutrients and phytochemicals and minimizing intake of dietary factors implicated in several chronic diseases.


Assuntos
Doença Crônica/prevenção & controle , Dieta com Restrição de Gorduras , Dieta Vegetariana , Neoplasias da Próstata/dietoterapia , Idoso , Antioxidantes/administração & dosagem , Carotenoides/administração & dosagem , Registros de Dieta , Gorduras na Dieta/administração & dosagem , Gorduras na Dieta/efeitos adversos , Fibras na Dieta/administração & dosagem , Progressão da Doença , Humanos , Isoflavonas/administração & dosagem , Masculino , Minerais/administração & dosagem , Valor Nutritivo , Resultado do Tratamento , Vitaminas/administração & dosagem
17.
Eur J Pharm Sci ; 122: 125-133, 2018 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-29940217

RESUMO

PURPOSE: A novel sublingual buprenorphine/naloxone rapidly-dissolving tablet (BNX-RDT) for opioid substitution therapy has been developed for improved bioavailability, rapid disintegration and improved taste masking. We compared the bioavailability and pharmaceutical properties of BNX-RDT with conventional buprenorphine/naloxone sublingual tablets (BNX). METHODS: Fasting, open-label, randomized, single-dose, two-cohort crossover study in healthy volunteers under naltrexone block. Cohort 1 (high-dose, N = 64) received BNX-RDT 11.4/2.9 mg and BNX 16/4 mg. Cohort 2 (low-dose, N = 61) received BNX-RDT 2.9/0.71 mg and BNX 4/1 mg. Plasma samples were collected over 72 h. Relative systemic exposures of buprenorphine and naloxone were assessed using standard statistical models for bioequivalence analysis. Pharmaceutical assessments included dissolve time, taste and mouthfeel assessments, and overall preference. RESULTS: BNX-RDT 11.4/2.9 mg provided equivalent buprenorphine and naloxone exposure to BNX 16/4 mg. BNX-RDT 2.9/0.71 mg provided ~20% lower buprenorphine and 35% lower naloxone exposure compared with BNX 4/1 mg. The comparison of BNX-RDT 2.9/0.71 mg with BNX 4/1 mg did not fully meet equivalence criteria. BNX-RDT was associated with improved dose proportionality across strengths compared with BNX (post hoc analysis), resulting in lower exposure from BNX-RDT relative to BNX at the lower strength. Median perceived dissolve times were significantly shorter for BNX-RDT than BNX at high (8.5 versus 16.2 min) and low (7.6 versus 9.1 min) doses. Taste and mouthfeel were rated significantly more pleasant than BNX, with ~78% of subjects preferring BNX-RDT. CONCLUSION: BNX-RDT provided improved buprenorphine absorption compared to a conventional sublingual tablet, with shorter dissolve times and improved taste and mouthfeel, resulting in a high preference for the novel formulation.


Assuntos
Analgésicos Opioides/administração & dosagem , Combinação Buprenorfina e Naloxona/administração & dosagem , Naloxona/administração & dosagem , Administração Sublingual , Adulto , Analgésicos Opioides/sangue , Analgésicos Opioides/farmacocinética , Disponibilidade Biológica , Combinação Buprenorfina e Naloxona/sangue , Combinação Buprenorfina e Naloxona/farmacocinética , Estudos Cross-Over , Feminino , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-Idade , Naloxona/sangue , Naloxona/farmacocinética , Tratamento de Substituição de Opiáceos , Comprimidos , Adulto Jovem
18.
J Hosp Adm ; 7(2): 36-49, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29682132

RESUMO

Background: In fall 2016, Augusta University received a two-year grant from AHRQ, to implement a Social Knowledge Networking (SKN) system for enabling its health system, AU-Health, to progress from "limited use" of EHR Medication Reconciliation (MedRec) Technology, to "meaningful use." Phase 1 sought to identify a comprehensive set of issues related to EHR MedRec encountered by practitioners at AU-Health. These efforts helped develop a Reporting Tool, which, along with a Discussion Tool, was incorporated into the AU-Health EHR, at the end of Phase 1. Phase 2 (currently underway), comprises a 52-week pilot of the EHR-integrated SKN system in outpatient and inpatient medicine units. The purpose of this paper is to describe the methods and results of Phase 1. Methods: Phase 1 utilized an exploratory mixed-method approach, involving two rounds of data collection. This included 15 individual interviews followed by a survey of 200 practitioners, i.e., physicians, nurses, and pharmacists, based in the outpatient and inpatient medicine service at AU Health. Results: Thematic analysis of interviews identified 55 issue-items related to EHR MedRec under 9 issue-categories. The survey sought practitioners' importance-rating of all issue-items identified from interviews. A total of 127 (63%) survey responses were received. Factor analysis served to validate the following 6 of the 9 issue-categories, all of which, were rated "Important" or higher (on average), by over 70% of all respondents: 1) Care-Coordination (CCI); 2) Patient-Education (PEI); 3) Ownership-and-Accountability (OAI); 4) Processes-of-Care (PCI); 5) IT-Related (ITRI); and 6) Workforce-Training (WTI). Significance-testing of importance-rating by professional affiliation revealed no statistically significant differences for CCI and PEI; and some statistically significant differences for OAI, PCI, ITRI, and WTI. Conclusion: There were two key gleanings from the issues related to EHR MedRec unearthed by this study: 1) there was an absence of shared understanding among practitioners, of the value of EHR MedRec in promoting patient safety, which contributed to workarounds, and suboptimal use of the EHR MedRec system; and 2) there was a socio-technical dimension to many of the issues, creating an added layer of complexity. These gleanings in turn, provide insights into best practices for managing both clinical transitions-of-care in the EHR MedRec process; and socio-technical challenges encountered in EHR MedRec implementation.

19.
Nat Ecol Evol ; 2(1): 71-80, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29230028

RESUMO

Most seafloor communities at depths below the photosynthesis zone rely on food that sinks through the water column. However, the nature and strength of this pelagic-benthic coupling and its influence on the structure and diversity of seafloor communities is unclear, especially around Antarctica where ecological data are sparse. Here we show that the strength of pelagic-benthic coupling along the East Antarctic shelf depends on both physical processes and the types of benthic organisms considered. In an approach based on modelling food availability, we combine remotely sensed sea-surface chlorophyll-a, a regional ocean model and diatom abundances from sediment grabs with particle tracking and show that fluctuating seabed currents are crucial in the redistribution of surface productivity at the seafloor. The estimated availability of suspended food near the seafloor correlates strongly with the abundance of benthic suspension feeders, while the deposition of food particles correlates with decreasing suspension feeder richness and more abundant deposit feeders. The modelling framework, which can be modified for other regions, has broad applications in conservation and management, as it enables spatial predictions of key components of seafloor biodiversity over vast regions around Antarctica.


Assuntos
Biodiversidade , Cadeia Alimentar , Invertebrados/fisiologia , Animais , Regiões Antárticas , Organismos Aquáticos/fisiologia , Diatomáceas , Modelos Biológicos , Oceanos e Mares , Água do Mar/química
20.
Sci Rep ; 8(1): 3183, 2018 02 16.
Artigo em Inglês | MEDLINE | ID: mdl-29453356

RESUMO

Antarctic coastal polynyas are regions of persistent open water and are thought to be key bio-physical features within the sea-ice zone. However, their use by the upper trophic levels of ecosystems remains unclear. A unique bio-physical dataset recorded by southern elephant seals reveals that East Antarctic polynyas are a key winter foraging habitat for male seals. During their post-moult trips from Isles Kerguelen to the Antarctic continental shelf, a total of 18 out of 23 seals visited 9 different polynyas, spending on average 25 ± 20% (up to 75%) of their total trip time inside polynyas. Changes in seal foraging and diving behaviours are observed inside polynyas as compared to outside polynyas. Two polynya usages by seals are observed for the inactive and active polynya phases, pointing to different seasonal peaks in prey abundance. During the active polynya phase, we link seal foraging behaviour to changes in the physical stability of the water-column, which likely impact the seasonal biological dynamics within polynyas.


Assuntos
Comportamento Animal/fisiologia , Comportamento Alimentar/fisiologia , Focas Verdadeiras/fisiologia , Animais , Regiões Antárticas , Mergulho , Ecossistema , Ambientes Extremos , Camada de Gelo , Oceanos e Mares , Estações do Ano , Temperatura
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