RESUMEN
Current calls to correct the perturbed ecosystems and nutrient imbalances of the Laurentian Great Lakes focus on setting target nutrient levels that will be met by environmental and economic regulations to reduce the flow of excess nutrients into the lakes. While these standard types of regulations have been successful in the past, it is unclear whether they will achieve similar ecological and economic successes now amid possible ecosystem regime shifts triggered by invasive mussels. We compute the bioeconomic costs and benefits of hypothetical regulations designed to target nutrient loads in present-day Lake Michigan through agricultural operations, which are known to be nonpoint source polluters of the aquatic ecosystem network. Our results show how reducing nutrient loads may exacerbate spatially disparate ecosystem issues that generate overall economic losses. Conversely, and counterintuitively, allowing for more nutrient loading could generate economic gains over our assessment timeframe. We determine that implementation of standard nutrient target policies are costly and likely inadequate for current dreissenid-affected aquatic ecosystems experiencing nutrient imbalances because they disregard the interactive role of invasive mussels in nutrient cycling.
Asunto(s)
Bivalvos , Lagos , Animales , Ecosistema , MichiganRESUMEN
The objectives of this study are to evaluate the effects of (1) a potential interaction between supplement crude protein (CP) concentration and differing cow genotypes on milk production, (2) differing cow genotypes on milk production, and (3) decreasing the supplement CP concentration on milk production and N excretion during the main grazing season within a spring-calving herd. A 2 × 2 factorial arrangement experiment, with 2 feeding strategies [14%; n = 30 (lower CP; LCP) and 18%; n = 28 (higher CP; HCP) CP concentrate supplements] offered at varying levels according to pasture availability and days in milk (DIM) was conducted over the main grazing season from April 3 to September 3, 2019, at University College Dublin Lyons Farm. Cows were also grouped into 2 genotype groups: lower milk genotype; n = 30 [LM; milk kg predicted transmitting ability (PTA): 45 ± 68.6 (mean ± SD); fat kg PTA: 10 ± 4.9; and protein kg PTA: 7 ± 2.3] and higher milk genotype; n = 28 [HM; milk kg PTA: 203 ± 55.0; fat kg PTA: 13 ± 3.8; and protein kg PTA: 10 ± 2.4]. A total of 46 multiparous and 12 primiparous (total; 58) Holstein Friesian dairy cows were blocked on parity and balanced on DIM, body condition score, and Economic Breeding Index. Cows were offered a basal diet of grazed perennial ryegrass pasture. The N partitioning study took place from August 25 to 30, 2019 (187 ± 15.2 DIM). No interactions were observed for any milk production or milk composition parameter. No effect of supplement CP concentration was observed for any total accumulated milk production, daily milk production, or milk composition parameter measured. The HM cows had increased daily milk yield (+1.9 kg), fat and protein (+0.15 kg), and energy-corrected milk (+1.7 kg), compared with the LM cows. Furthermore, HM cows had decreased milk protein concentration (-0.1%) compared with LM cows. For the N partitioning study, cows offered LCP had increased pasture dry matter intake (PDMI; +0.9 kg/d), dietary N intake (+0.022 kg/d), feces N excretion (+0.016 kg/d), and decreased N partitioning to milk (-2%), and N utilization efficiency (-2.3%). In conclusion, offering cows LCP had no negative influence on milk production or milk composition over the main grazing season where high pasture quality was maintained. However, any potential negative effects of offering LCP on milk production may have been offset by the increased PDMI. Furthermore, offering cows LCP decreased N utilization efficiency due to the higher PDMI and feed N intake associated with cows on this treatment in our study.
Asunto(s)
Alimentación Animal , Nitrógeno , Alimentación Animal/análisis , Animales , Bovinos , Dieta/veterinaria , Femenino , Lactancia , Leche , Embarazo , Estaciones del AñoRESUMEN
OBJECTIVES: To evaluate long term effectiveness and safety with the use of a combined radiofrequency and optical home hair removal device in all skin types and over both facial and body areas. METHODS: A combined intense pulsed light (IPL) and radiofrequency (RF) home device was used for hair removal. Two separate study designs were evaluated. In the first design, bilateral body areas were treated with 7 weekly procedures and then unilateral areas received up to 12 monthly maintenance treatments while the corresponding other side received no further therapy. For the second design, facial areas received 4 procedures in 2 to 5 days visits, followed by 2 weekly, and then 6 biweekly procedures. All patients in both study designs had hair count evaluations up to 12 months post their last procedure. The highest energy used was 4 J/cm². RESULTS: In the first design, 58 subjects participated of which 15% were skin types V-VI. A total of 188 anatomical sites were treated. Hair reduction at 6 and 12 months post the last procedure was 56% and 52% respectively for the maintenance side and 47% and 37% for the non-maintenance side. For the second design, 19 subjects had 59 facial sites treated. Fifteen percent were skin types V –VI. The overall hair reduction at the end of receiving their procedures was 45%. At 12 months post the last procedure, the hair reduction was 42%. Aside for transient mild erythema, there were no adverse effects noted. CONCLUSIONS: Long term persistent hair reduction was achieved using an RF/IPL home-use hair reduction device. The combination of RF and optical energies allowed for the effective application of low energy usage. All skin types and both facial and body anatomical regions tolerated the procedures very well. J Drugs Dermatol. 2020;19(5):498-503. doi:10.36849/JDD.2020.4741.
Asunto(s)
Eritema/diagnóstico , Remoción del Cabello/instrumentación , Cabello/efectos de la radiación , Luz/efectos adversos , Ondas de Radio/efectos adversos , Adolescente , Adulto , Anciano , Eritema/etiología , Femenino , Estudios de Seguimiento , Cabello/diagnóstico por imagen , Remoción del Cabello/efectos adversos , Remoción del Cabello/métodos , Humanos , Masculino , Persona de Mediana Edad , Fotograbar , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Adulto JovenRESUMEN
Bone marrow-derived mesenchymal stem/stromal cells (BMSC) may facilitate bone repair through secretion of factors that stimulate endogenous repair processes or through direct contribution to new bone through differentiation into osteoblast-like cells. BMSC microtissue culture and differentiation has been widely explored recently, with high-throughput platforms making large-scale manufacture of microtissues increasingly feasible. Bone-like BMSC microtissues could offer an elegant method to enhance bone repair, especially in small-volume non-union defects, where small diameter microtissues could be delivered orthoscopically. Using a high-throughput microwell platform, our data demonstrate that (1) BMSC in 3D microtissue culture result in tissue compaction, rather than growth, (2) not all mineralised bone-like matrix is incorporated in the bulk microtissue mass and (3) a significant amount of lipid vacuole formation is observed in BMSC microtissues exposed to BMP-2. These factors should be considered when optimising BMSC osteogenesis in microtissues or developing BMSC microtissue-based therapeutic delivery processes.
Asunto(s)
Adipogénesis/efectos de los fármacos , Proteína Morfogenética Ósea 2/farmacología , Medios de Cultivo/farmacología , Células Madre Mesenquimatosas/citología , Osteogénesis/efectos de los fármacos , Técnicas de Cultivo de Tejidos , Ingeniería de Tejidos , Calcio/metabolismo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
Osteoarthritis results from the degradation of articular cartilage and is one of the leading global causes of pain and immobility. Cartilage has a limited capacity for self-repair. While repair can be enhanced through surgical intervention, current methods often generate inferior fibrocartilage and repair is transient. The development of tissue engineering strategies to improve repair outcomes is an active area of research. While small animal models such as rodents and rabbits are often used in early pre-clinical work, larger animals that better recapitulate the anatomy and loading of the human joint are required for late-stage preclinical evaluation. Because of their physiological similarities to humans, and low cost relative to other large animals, sheep are routinely used in orthopedic research, including cartilage repair studies. In recent years, there has been considerable research investment into the development of cartilage repair strategies that utilize mesenchymal stem/stromal cells (MSC). In contrast to autologous chondrocytes derived from biopsies of articular cartilage, MSC offer some benefits including greater expansion capacity and elimination of the risk of morbidity at the cartilage biopsy site. The disadvantages of MSC are related to the challenges of inducing and maintaining a stable chondrocyte-like cell population capable of generating hyaline cartilage. Ovine MSC (oMSC) biology and their utility in sheep cartilage repair models have not been reviewed. Herein, we review the biological properties of MSC derived from sheep tissues, and the use of these cells to study articular cartilage repair in this large animal model.
Asunto(s)
Cartílago Articular/cirugía , Trasplante de Células Madre Mesenquimatosas , Animales , Cartílago Articular/patología , Células Cultivadas , Células Madre Mesenquimatosas , Modelos Animales , Osteoartritis/cirugía , OvinosRESUMEN
Relapsing polychondritis (RPC) is a rare, immune-mediated condition affecting approximately 3.5 per million population per year. Neurological involvement in RPC is still rarer and is presumed to be the result of a vasculitic process, although this is seldom confirmed in the literature. We present two cases of RPC complicated by cognitive dysfunction with contrasting clinical trajectories. Our findings suggest that there are two clinical phenotypes of cognitive dysfunction in RPC. The first is a fulminant, multisystem presentation with sub-acute cognitive decline mimicking central nervous system vasculitis, and we provide histopathological evidence of this process occurring. The other is an insidious cognitive decline without associated constitutional or systemic symptoms.
Asunto(s)
Trastornos del Conocimiento/complicaciones , Policondritis Recurrente/etiología , Anciano , Encéfalo/patología , Trastornos del Conocimiento/diagnóstico por imagen , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Policondritis Recurrente/diagnóstico por imagenRESUMEN
OBJECTIVE: Our aim was to assess the effectiveness of hydro-responsive wound dressing (HRWD) in debridement and wound bed preparation of a variety of acute and chronic wounds that presented with devitalised tissue needing removal so that healing may proceed. METHOD: This was a non-comparative evaluation of acute and chronic wounds that required debridement as part of their normal treatment regimen. Clinicians recorded wound changes including a subjective assessment level of devitalised tissue and wound bed preparation, presence of pain, wound status (e.g., wound size) and periwound skin condition. Data was also collected from clinicians and patients to provide information on clinical performance of the dressing. RESULTS: We recruited 100 patients with a variety of wound types into the study. Over 90% of the clinicians reported removal of devitalised tissue to enable a healing response in both chronic and acute wounds. Specifically, over the course of the evaluation period, levels of devitalised tissue (necrosis and slough) reduced from 85.5% to 26.3%, and this was accompanied by an increase in wound bed granulation from 12.0% to 33.7%. Correspondingly, there was a 40% reduction in wound area, hence a clinically relevant healing response was seen upon treatment with HRWD. It is also noteworthy that this patient population included a significant proportion of chronic wounds (51.4%) that showed no signs of wound progression within <4 weeks before study inclusion. Of these chronic wounds, 93% demonstrated wound progression upon treatment with HRWD. Despite reported pain levels being low pre- and post-dressing change, overall wound pain improved (reduced) in 48% of patients. Periwound skin condition showed a tendency towards improvement, and the fluid management capabilities of the HRWD was reported as good to excellent in the majority of cases. Wound infections were reduced by at least 60% over the evaluation period. A simple cost-effective analysis demonstrated significant savings using HRWD (£6.33) over current standard practice regimens of a four-step debridement process (£8.05), larval therapy (£306.39) and mechanical pad debridement (£11.46). CONCLUSION: HRWD was well tolerated and was demonstrated to be an efficient debridement tool providing rapid, effective and pain free debridement in a variety of wound types.
Asunto(s)
Autólisis , Vendajes , Desbridamiento/métodos , Heridas y Lesiones/terapia , Anciano , Anciano de 80 o más Años , Análisis Costo-Beneficio , Exudados y Transudados , Femenino , Humanos , Masculino , Persona de Mediana Edad , Repitelización , Escocia , Resultado del Tratamiento , Infección de Heridas/prevención & controlRESUMEN
Identifying which nonindigenous species will become invasive and forecasting the damage they will cause is difficult and presents a significant problem for natural resource management. Often, the data or resources necessary for ecological risk assessment are incomplete or absent, leaving environmental decision makers ill equipped to effectively manage valuable natural resources. Structured expert judgment (SEJ) is a mathematical and performance-based method of eliciting, weighting, and aggregating expert judgments. In contrast to other methods of eliciting and aggregating expert judgments (where, for example, equal weights may be assigned to experts), SEJ weights each expert on the basis of his or her statistical accuracy and informativeness through performance measurement on a set of calibration variables. We used SEJ to forecast impacts of nonindigenous Asian carp (Hypophthalmichthys spp.) in Lake Erie, where it is believed not to be established. Experts quantified Asian carp biomass, production, and consumption and their impact on 4 fish species if Asian carp were to become established. According to experts, in Lake Erie Asian carp have the potential to achieve biomass levels that are similar to the sum of biomasses for several fishes that are harvested commercially or recreationally. However, the impact of Asian carp on the biomass of these fishes was estimated by experts to be small, relative to long term average biomasses, with little uncertainty. Impacts of Asian carp in tributaries and on recreational activities, water quality, or other species were not addressed. SEJ can be used to quantify key uncertainties of invasion biology and also provide a decision-support tool when the necessary information for natural resource management and policy is not available.
Asunto(s)
Carpas/fisiología , Conservación de los Recursos Naturales/métodos , Especies Introducidas , Animales , Explotaciones Pesqueras , Peces/fisiología , Predicción , Humanos , Lagos , Ontario , Dinámica Poblacional , Recreación , Medición de Riesgo , Estados UnidosRESUMEN
In this paper, we report results of radiation dose measurements in fingernails of a worker who sustained a radiation injury to his right thumb while using 130 kVp X-ray for nondestructive testing. Clinically estimated absorbed dose was about 20-25 Gy. Electron paramagnetic resonance (EPR) dose assessment was independently carried out by two laboratories, the Naval Dosimetry Center (NDC) and French Institut de Radioprotection et de Sûreté Nucléaire (IRSN). The laboratories used different equipments and protocols to estimate doses in the same fingernail samples. NDC used an X-band transportable EPR spectrometer, e-scan produced by Bruker BioSpin, and a universal dose calibration curve. In contrast, IRSN used a more sensitive Q-band stationary spectrometer (EMXplus) with a new approach for the dose assessment (dose saturation method), derived by additional dose irradiation to known doses. The protocol used by NDC is significantly faster than that used by IRSN, nondestructive, and could be done in field conditions, but it is probably less accurate and requires more sample for the measurements. The IRSN protocol, on the other hand, potentially is more accurate and requires very small amount of sample but requires more time and labor. In both EPR laboratories, the intense radiation-induced signal was measured in the accidentally irradiated fingernails and the resulting dose assessments were different. The dose on the fingernails from the right thumb was estimated as 14 ± 3 Gy at NDC and as 19 ± 6 Gy at IRSN. Both EPR dose assessments are given in terms of tissue kerma. This paper discusses the experience gained by using EPR for dose assessment in fingernails with a stationary spectrometer versus a portable one, the reasons for the observed discrepancies in dose, and potential advantages and disadvantages of each approach for EPR measurements in fingernails.
Asunto(s)
Exposición a Riesgos Ambientales/análisis , Uñas/efectos de la radiación , Dosis de Radiación , Liberación de Radiactividad Peligrosa , Radiometría/métodos , Espectroscopía de Resonancia por Spin del Electrón , HumanosRESUMEN
Appropriate allocation of rheumatology clinic appointments depends on the information contained in referral letters. Such letters were analysed for the presence of pertinent information and a scoring system was devised to assess the quality of enclosed data. In a smaller cohort, relevant basic tests were carried out prior to the appointment. 122 referral letters were received over a 1 month period. Symptom duration was documented in (39) 32%, while (64) 52.5% listed medications. Only (23) 17.2% indicated the urgency of the problem. Approximately (31) 25% of referrers performed relevant routine investigations. Mean score out of 10 was 5.1 (range 1.5-9). Of the 40 (33%) patients with pre-appointment investigations, the clinic attendance rate and subsequent discharge rate were significantly higher than those without these tests. This study shows that comprehensive referral letters and basic investigations significantly help to prioritize appointments and facilitate earlier diagnosis and treatment for patients with rheumatic disease.
Asunto(s)
Citas y Horarios , Servicio Ambulatorio en Hospital/organización & administración , Derivación y Consulta , Enfermedades Reumáticas/terapia , Toma de Decisiones , Femenino , Humanos , MasculinoRESUMEN
The objectives of this study were to evaluate the effects of (1) protein supplementation strategy, (2) cow genotype and (3) an interaction between protein supplementation strategy and cow genotype on milk production and nitrogen (N) utilisation efficiency (milk N output/ total dietary N intake × 100; NUE) in late-lactation, spring-calving grazing dairy cows. A 2 × 2 factorial arrangement experiment, with two feeding strategies [13% (lower crude protein; LCP) and 18% CP (higher CP; HCP) supplements with equal metabolisable protein supply] offered at 3.6 kg dry matter/cow perday, and two cow genotype groups [lower milk genotype (LM) and higher milk genotype (HM)], was conducted over 53 days. Cows were offered 15 kg dry matter of grazed herbage/cow/day. Herbage intake was controlled using electric strip wires which allowed cows to graze their daily allocation-only. There was an interaction for herbage dry matter intake within cows offered HCP, where higher milk genotype (HM) cows had increased herbage dry matter intake (+0.58 kg) compared to lower milk genotype (LM) cows. Offering cows LCP decreased fat + protein yield (-110 g) compared to offering cows HCP. Offering cows LCP decreased the total feed N proportion that was recovered in the urine (-0.007 proportion units) and increased the total feed N proportion that was recovered in the faeces (+0.008 proportion units) compared to offering cows HCP. In conclusion, our study shows that reducing the supplementary CP concentration from 18% to 13% resulted in decreased milk production (-9.8%), reduced partitioning of total feed N to urine (-0.9%) and increased partitioning of total feed N to faeces (+14%) in late lactation, grazing dairy cows.
RESUMEN
Mesenchymal stem cells (MSC) are emerging as a leading cellular therapy for a number of diseases. However, for such treatments to become available as a routine therapeutic option, efficient and cost-effective means for industrial manufacture of MSC are required. At present, clinical grade MSC are manufactured through a process of manual cell culture in specialized cGMP facilities. This process is open, extremely labor intensive, costly, and impractical for anything more than a small number of patients. While it has been shown that MSC can be cultivated in stirred bioreactor systems using microcarriers, providing a route to process scale-up, the degree of numerical expansion achieved has generally been limited. Furthermore, little attention has been given to the issue of primary cell isolation from complex tissues such as placenta. In this article we describe the initial development of a closed process for bulk isolation of MSC from human placenta, and subsequent cultivation on microcarriers in scalable single-use bioreactor systems. Based on our initial data, we estimate that a single placenta may be sufficient to produce over 7,000 doses of therapeutic MSC using a large-scale process.
Asunto(s)
Técnicas de Cultivo de Célula/métodos , Separación Celular/métodos , Células Madre Mesenquimatosas/citología , Placenta/citología , Diferenciación Celular , Proliferación Celular , Células Cultivadas , Femenino , Humanos , EmbarazoRESUMEN
OBJECTIVES: To develop evidence-based European League Against Rheumatism (EULAR) recommendations for vaccination in patients with autoimmune inflammatory rheumatic diseases (AIIRD). METHODS: A EULAR task force was composed of experts representing 11 European countries, consisting of eight rheumatologists, four clinical immunologists, one rheumatologist/clinical immunologist, one infectious disease physician, one nephrologist, one paediatrician/rheumatologist and one clinical epidemiologist. Key questions were formulated and the eligible spectrum of AIIRD, immunosuppressive drugs and vaccines were defined in order to perform a systematic literature review. A search was made of Medline from 1966 to October 2009 as well as abstracts from the EULAR meetings of 2008 and 2009 and the American College of Rheumatology (ACR) meetings of 2007 and 2008. Evidence was graded in categories I-IV, the strength of recommendations was graded in categories A-D and Delphi voting was applied to determine the level of agreement between the experts of the task force. RESULTS: Eight key questions and 13 recommendations addressing vaccination in patients with AIIRD were formulated. The strength of each recommendation was determined. Delphi voting revealed a very high level of agreement with the recommendations among the experts of the task force. Finally, a research agenda was proposed. CONCLUSION: Recommendations for vaccination in patients with AIIRD based on the currently available evidence and expert opinion were formulated. More research is needed, particularly regarding the incidence of vaccine-preventable infectious diseases and the safety of vaccination in patients with AIIRD.
Asunto(s)
Enfermedades Autoinmunes/complicaciones , Infecciones Oportunistas/complicaciones , Infecciones Oportunistas/prevención & control , Enfermedades Reumáticas/complicaciones , Vacunación , Enfermedades Autoinmunes/tratamiento farmacológico , Técnica Delphi , Medicina Basada en la Evidencia/métodos , Humanos , Inmunosupresores/efectos adversos , Enfermedades Reumáticas/tratamiento farmacológicoRESUMEN
Patients with inflammatory arthritis are at increased risk of vaccine preventable infections. This risk is increased by immunomodulatory therapies. Vaccination for influenza and pneumococcal disease reduces the risk. Severe cases of varicella infection have occurred in patients on biologic therapies. We sought to identify vaccination rates for commonly acquired infections and to ascertain varicella immune status in patients with inflammatory arthritis. 100 patients with inflammatory arthritis were administered a standardised questionnaire. Data collected included age, diagnosis, vaccination history, history of varicella, treatment and the presence of other indications for vaccination. 58 patients (58%) had not received the influenza vaccine in the past year. Only 19 patients (19%) had ever received pneumococcal vaccine. Anti TNF use did not predict vaccination (p = .46). An increasing number of co morbid conditions predicted both pneumococcal (p < 0.003) and influenza vaccine (p < 0.03) administration. Nineteen patients (19%) gave no history of varicella infection, none having had varicella titres checked pre treatment. Immunisation rates in patients with inflammatory arthritis on immunosuppressive therapies are low. Immunisation schedules should be available for each patient during rheumatology and general practice consultations.
Asunto(s)
Artritis Reumatoide/inmunología , Varicela/inmunología , Vacunas contra la Influenza/administración & dosificación , Gripe Humana/prevención & control , Infecciones Neumocócicas/prevención & control , Vacunas Neumococicas/administración & dosificación , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Comorbilidad , Femenino , Humanos , Gripe Humana/inmunología , Irlanda , Masculino , Persona de Mediana Edad , Infecciones Neumocócicas/inmunología , Encuestas y CuestionariosRESUMEN
Bone marrow stromal cells (BMSC) show promise in cartilage repair, and sheep are the most common large animal pre-clinical model. OBJECTIVE: The objective of this study was to characterise ovine BMSC (oBMSC) in vitro, and to evaluate the capacity of chondrogenic micro-pellets manufactured from oBMSC or ovine articular chondrocytes (oACh) to repair osteochondral defects in sheep. DESIGN: oBMSC were characterised for surface marker expression using flow cytometry and evaluated for tri-lineage differentiation capacity. oBMSC micro-pellets were manufactured in a microwell platform, and chondrogenesis was compared at 2%, 5%, and 20% O2. The capacity of cartilage micro-pellets manufactured from oBMSC or oACh to repair osteochondral defects in adult sheep was evaluated in an 8-week pilot study. RESULTS: Expanded oBMSC were positive for CD44 and CD146 and negative for CD45. The common adipogenic induction ingredient, 3-Isobutyl-1-methylxanthine (IBMX), was toxic to oBMSC, but adipogenesis could be restored by excluding IBMX from the medium. BMSC chondrogenesis was optimal in a 2% O2 atmosphere. Micro-pellets formed from oBMSC or oACh appeared morphologically similar, but hypertrophic genes were elevated in oBMSC micro-pellets. While oACh micro-pellets formed cartilage-like repair tissue in sheep, oBMSC micro-pellets did not. CONCLUSION: The sensitivity of oBMSC, compared to human BMSC, to IBMX in standard adipogenic assays highlights species-associated differences. Micro-pellets manufactured from oACh were more effective than micro-pellets manufactured from oBMSC in the repair of osteochondral defects in sheep. While oBMSC can be driven to form cartilage-like tissue in vitro, the effective use of these cells in cartilage repair will depend on the successful mitigation of hypertrophy and tissue integration.
Asunto(s)
Cartílago Articular , Células Madre Mesenquimatosas , Animales , Médula Ósea , Células de la Médula Ósea , Cartílago , Diferenciación Celular , Células Cultivadas , Condrocitos , Condrogénesis , Proyectos Piloto , OvinosRESUMEN
UNLABELLED: There are several types of serious nuclear or radiologic emergencies that would require a specialized medical response. Four scenarios of great public health, economic, and psychologic impact are the detonation of a nuclear weapon, the meltdown of a nuclear reactor, the explosion of a large radiologic dispersal device ("dirty bomb"), or the surreptitious placement of a radiation exposure device in a public area of high population density. With any of these, medical facilities that remain functional may have to deal with large numbers of ill, wounded, and probably contaminated people. Special care and/or handling will be needed for those with trauma, blast injuries, or thermal burns as well as significant radiation exposures or contamination. In addition, radiologists, nuclear medicine specialists, and radiation oncologists will be called on to perform a number of diverse and critically important tasks, including advising political and public health leaders, interfacing with the media, managing essential resources, and, of course, providing medical care. This article describes the medical responses needed following a radiologic or nuclear incident, including the symptoms of and specific treatments for acute radiation syndrome and other early health effects. SUPPLEMENTAL MATERIAL: http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.09090330/-/DC1.
Asunto(s)
Planificación en Desastres , Exposición Profesional/efectos adversos , Rol del Médico , Traumatismos por Radiación/prevención & control , Liberación de Radiactividad Peligrosa , Administración de la Seguridad/métodos , Descontaminación , Guías como Asunto , Física Sanitaria , Humanos , Guerra Nuclear , Armas Nucleares , Salud Pública , Dosis de Radiación , Monitoreo de Radiación , Protección Radiológica/métodos , TerrorismoRESUMEN
Compartments in food webs are subgroups of taxa in which many strong interactions occur within the subgroups and few weak interactions occur between the subgroups. Theoretically, compartments increase the stability in networks, such as food webs. Compartments have been difficult to detect in empirical food webs because of incompatible approaches or insufficient methodological rigour. Here we show that a method for detecting compartments from the social networking science identified significant compartments in three of five complex, empirical food webs. Detection of compartments was influenced by food web resolution, such as interactions with weights. Because the method identifies compartmental boundaries in which interactions are concentrated, it is compatible with the definition of compartments. The method is rigorous because it maximizes an explicit function, identifies the number of non-overlapping compartments, assigns membership to compartments, and tests the statistical significance of the results. A graphical presentation reveals systemic relationships and taxa-specific positions as structured by compartments. From this graphic, we explore two scenarios of disturbance to develop a hypothesis for testing how compartmentalized interactions increase stability in food webs.
Asunto(s)
Cadena Alimentaria , Modelos Biológicos , Conducta Social , Algoritmos , Animales , Humanos , Estados UnidosRESUMEN
Many forms of rapidly progressive cognitive impairment are irreversible and rarely treatable. We present a case of autoimmune limbic encephalitis associated with voltage-gated potassium channel autoantibodies that led to rapid cognitive deterioration and bizarre behaviour, which subsequently improved following immunosuppressant therapy. The diagnosis of autoimmune limbic encephalitis needs to be considered in patients presenting with apparent viral encephalitis, in more unusual clinical situations in subjects with acute psychiatric illness and in cases of refractory epilepsy, particularly if there is evidence of amnesia. The diagnosis depends on the detection of specific antibodies directed against central nervous system targets. There can be a good response to immunosuppressant therapy.
Asunto(s)
Amnesia/complicaciones , Enfermedades Autoinmunes/complicaciones , Encefalitis Límbica/complicaciones , Convulsiones/complicaciones , Amnesia/tratamiento farmacológico , Enfermedades Autoinmunes/diagnóstico , Enfermedades Autoinmunes/tratamiento farmacológico , Diagnóstico Diferencial , Progresión de la Enfermedad , Humanos , Inmunosupresores/uso terapéutico , Encefalitis Límbica/diagnóstico , Encefalitis Límbica/tratamiento farmacológico , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Convulsiones/tratamiento farmacológicoRESUMEN
A previous study identified kartogenin (KGN) as a potent modulator of bone marrow mesenchymal stem/stromal cell (BMSC) chondrogenesis. This initial report did not contrast KGN directly against transforming growth factor-beta 1 (TGF-ß1), the most common growth factor used in chondrogenic induction medium. Herein, we directly compared the in vitro chondrogenic potency of TGF-ß1 and KGN using a high resolution micropellet model system. Micropellets were cultured for 7-14 days in medium supplemented with TGF-ß1, KGN, or both TGF-ß1 + KGN. Following 14 days of induction, micropellets exposed to TGF-ß1 alone or TGF-ß1 + KGN in combination were larger and produced more glycosominoglycan (GAG) than KGN-only cultures. When TGF-ß1 + KGN was used, GAG quantities were similar or slightly greater than the TGF-ß1-only cultures, depending on the BMSC donor. BMSC micropellet cultures supplemented with KGN alone contracted in size over the culture period and produced minimal GAG. Indicators of hypertrophy were not mitigated in TGF-ß1 + KGN cultures, suggesting that KGN does not obstruct BMSC hypertrophy. KGN appears to have weak chondrogenic potency in human BMSC cultures relative to TGF-ß1, does not obstruct hypertrophy, and may not be a viable alternative to growth factors in cartilage tissue engineering.
Asunto(s)
Anilidas/farmacología , Condrogénesis/efectos de los fármacos , Células Madre Mesenquimatosas/efectos de los fármacos , Ácidos Ftálicos/farmacología , Ingeniería de Tejidos/métodos , Factor de Crecimiento Transformador beta1/farmacología , Cartílago/crecimiento & desarrollo , Diferenciación Celular/efectos de los fármacos , Células Cultivadas , Medios de Cultivo/farmacología , Humanos , Células Madre Mesenquimatosas/fisiología , Cultivo Primario de Células/métodos , Proteínas Recombinantes/farmacologíaRESUMEN
Bighead carp H. nobilis and silver carp Hypothalmichthys molitrix (collectively bigheaded carps, BHC) are invasive planktivorous fishes that threaten to enter the Laurentian Great Lakes and disrupt food webs. To assess the likelihood of BHC establishment and their likely effects on the food web of Saginaw Bay, Lake Huron, we developed a multi-species individual-based bioenergetics model that tracks individual bighead and silver carp, four key fish species, and seven prey biomass groups over 50 years. The model tracks the daily consumption, mortality and growth of all individuals and the biomass dynamics of interacting prey pools. We ran simulation scenarios to determine the likelihood of BHC establishment under initial introductions from 5 to 1 million yearling and older individuals, and assuming variable age-0 carp survival rates (high, intermediate, and low). We bounded the survival of age-0 BHC as recruitment continues to be one of the biggest unknowns. We also simulated the potential effects of an established population of 1 million bighead carp or silver carp assuming variation in age-0 survival. Results indicated that as few as 10 BHC could establish a population assuming high or intermediate age-0 survival, but at least 100,000 individuals were needed to establish a population assuming low age-0 survival. BHC had negative effects on plankton and planktivorous fish biomass, which increased with BHC density. However, piscivorous walleye Sander vitreus appeared to benefit from BHC establishment. The potential for BHC to establish and affect ecologically and economically important fish species in Saginaw Bay is a cause for concern.