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Mandatory COVID-19 vaccination requirements for healthcare workers in the United States, instituted at the height of the pandemic to protect vulnerable patients and preserve the infrastructure of healthcare, nonetheless met with resistance by some members of the work force. As unprecedented numbers of employees sought religious accommodations, chaplain leaders were recruited by institutional leadership to adjudicate these requests, either alone or as part of a committee. This study reports results of a survey conducted from 6/1/2022 to 7/15/2022 with U.S. healthcare chaplains (n = 76) who were involved in the evaluation of coworker requests for religious exemption to the COVID-19 vaccine anytime during the pandemic until they accessed the survey. Chaplains were recruited online through national chaplaincy and ethics organizations. A mixed methods design facilitates integration of statistically significant associations with chaplains' in-depth reflections on their experience. Surveying the religious experts on the review committee affords a rare look into how the tension between the free exercise of religion in the workplace and the obligation to protect the public played out during the pandemic. The study further addresses a gap in research literature on the experience of chaplains during the pandemic and identifies unique features of moral injury experienced by a subset of healthcare providers. Chaplains largely perceived their involvement as promoting an ethical, informed process of review. Although all chaplains found this role stressful, high levels of meaning were protective against distress. Sources of distress identified included: ethical concern that granting exemptions would lead to the spread of the virus; inconsistencies in the review process; and, repeated exposure to coworkers' misunderstanding and political use of religious teachings. Featuring prominently in comments from chaplains was the difficulty navigating requests in the context of anti-science, anti-vaccine, and politically charged public discourse.
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Cartilage loses, recovers, and maintains its thickness, hydration, and biomechanical functions based on competing rates of fluid loss and recovery under varying joint-use conditions. While the mechanics and implications of load-induced fluid loss have been studied extensively, those of fluid recovery have not. This study isolates, quantifies, and compares rates of cartilage recovery from three known modes: (1) passive swelling - fluid recovery within a static unloaded contact area; (2) free swelling - unrestricted fluid recovery by an exposed surface; (3) tribological rehydration - fluid recovery within a loaded contact area during sliding. Following static loading of adult bovine articular cartilage to between 100 and 500 µm of compression, passive swelling, free swelling, and tribological rehydration exhibited average rates of 0.11 ± 0.04, 0.71 ± 0.15, and 0.63 ± 0.22 µm/s, respectively, over the first 100 s of recovery; for comparison, the mean exudation rate just prior to sliding was 0.06 ± 0.04 µm/s. For this range of compressions, we detected no significant difference between free swelling and tribological rehydration rates. However, free swelling and tribological rehydration rates, those associated with joint articulation, were â¼7-fold faster than passive swelling rates. While previous studies show how joint articulation prevents fluid loss indefinitely, this study shows that joint articulation reverses fluid loss following static loading at >10-fold the preceding exudation rate. These competitive recovery rates suggest that joint space and function may be best maintained throughout an otherwise sedentary day using brief but regular physical activity. STATEMENT OF SIGNIFICANCE: Cartilage loses, recovers, and maintains its thickness, hydration, and biomechanical functions based on competing rates of fluid loss and recovery under varying joint-use conditions. While load-induced fluid loss is extremely well studied, this is the first to define the competing modes of fluid recovery and to quantify their rates. The results show that the fluid recovery modes associated with joint articulation are 10-fold faster than exudation during static loading and passive swelling during static unloading. The results suggest that joint space and function are best maintained throughout an otherwise sedentary day using brief but regular physical activities.
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Cartílago Articular , Animales , Bovinos , PresiónRESUMEN
OBJECTIVE: Joint movements sustain cartilage fluid load support (FLS) through a combination of contact migration and periodic bath exposure. Although there have been suggestions that small involuntary movements may disrupt load-induced exudation during prolonged inactivity, theoretical studies have shown otherwise. This work used well-controlled explant measurements to experimentally test an existing hypothesis that the range-of-motion must exceed the contact length to sustain non-zero FLS. METHOD: Smooth glass spheres (1.2-3.2 mm radius) were slid at 1.5 mm/s (Péclet number >100) against bovine osteochondral explants under varying normal loads (0.05-0.1 N) and migration lengths (0.05-7 mm) using a custom instrument. In situ deformation measurements were used to quantify FLS. RESULTS: Non-zero FLS was maintained at migration lengths as small as 0.05 mm or <10% the typical contact diameter. FLS peaked when track lengths exceeded 10 times the contact diameter. For migration lengths below this threshold, FLS decreased with increased contact stress. CONCLUSIONS: Migration lengths far smaller than the contact diameter can sustain non-zero FLS, which, from a clinical perspective, indicates that fidgeting and drifting can mitigate exudation and loss of FLS during prolonged sitting and standing. Nonetheless, FLS decreased monotonically with decreased migration length when migration lengths were less than 10 times the contact diameter. The results demonstrate: (1) potential biomechanical benefits from small movement (e.g., drifting and fidgeting); (2) the quantitative limits of those benefits; (3) and how loads, movement patterns, and mobility likely impact long term FLS.
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Cartílago Articular/fisiología , Rango del Movimiento Articular/fisiología , Conducta Sedentaria , Líquido Sinovial/fisiología , Soporte de Peso , Animales , Fenómenos Biomecánicos , Bovinos , Presión HidrostáticaRESUMEN
Informal learning environments provide the opportunity to study guests' experiences as they engage with exhibits specifically designed to invoke the emotional experience of awe. The current paper presents insight gained by using both traditional survey measures and innovative mobile eye-tracking technology to examine guests' experiences of awe in a science museum. We present results for guests' visual attention in two exhibit spaces, one chosen for its potential to evoke positive awe and one for negative awe, and examine associations between visual attention and survey responses with regard to different facets of awe. In this exploratory study, we find relationships between how guests attend to features within an exhibit space (e.g., signage) and their feelings of awe. We discuss implications of using both methods concurrently to shed new light on exhibit design, and more generally for working in transdisciplinary multimethod teams to move scientific knowledge and application forward.
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Atención , Emociones/fisiología , Movimientos Oculares , Adolescente , Adulto , Femenino , Humanos , Conocimiento , Masculino , Museos , Encuestas y Cuestionarios , Adulto JovenRESUMEN
AIMS: Brain (central nervous system; CNS) metastases occur in 30-50% of patients with human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer (MBC). A substantive evidence base for treatment is lacking, but activity with lapatinib plus capecitabine (lap-cap) has been reported. We compared lap-cap with trastuzumab plus capecitabine (tras-cap) in patients with HER2-positive MBC with CNS metastases previously treated with trastuzumab. MATERIALS AND METHODS: This open-label randomised phase II screening trial aimed to randomise 130 participants over 2 years to receive lap-cap or tras-cap. Eligible patients had HER2-positive MBC with newly diagnosed or recently progressed CNS metastases; previous, or current, treatment included: trastuzumab, a taxane or anthracycline and recent completion of local cranial therapy. The primary end point was time to progression of CNS metastases within the 24-week trial period. Secondary objectives included CNS response rate, progression-free survival, steroid use for CNS symptoms and feasibility of recruitment to a large phase III trial. RESULTS: Between September 2011 and October 2013, 30 participants were randomised, 16 to lap-cap and 14 to tras-cap. Recruitment to a large phase III trial was determined not to be feasible. At 24 weeks, CNS disease progression was 41.8% (95% confidence interval 16.1-67.5%) in lap-cap and 41.2% (95% confidence interval 12.8-69.6%) in tras-cap arms; progression-free survival was 44.4% (95% confidence interval 18.1-70.8%) in lap-cap and 50.0% (95% confidence interval 20.9-79.1%) in tras-cap arms. CONCLUSION: Poor recruitment confirmed that a larger phase III trial would not be feasible and prohibited a preliminary evaluation of the superiority of lap-cap over tras-cap. Descriptive statistics are presented to inform the limited evidence base and future study design.
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Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias del Sistema Nervioso Central/tratamiento farmacológico , Receptor ErbB-2/metabolismo , Terapia Recuperativa , Neoplasias de la Mama/metabolismo , Neoplasias de la Mama/patología , Capecitabina/administración & dosificación , Neoplasias del Sistema Nervioso Central/metabolismo , Neoplasias del Sistema Nervioso Central/secundario , Femenino , Humanos , Lapatinib/administración & dosificación , Persona de Mediana Edad , Pronóstico , Tasa de Supervivencia , Trastuzumab/administración & dosificaciónRESUMEN
Certain metals can surprisingly build-up charge spontaneously, when exposed to high relative humidity (RH), although they need to be isolated from the ground. We have explored this phenomenon, building on former experimental knowledge and carrying out additional experiments, to identify the parameters that could enhance this charging. We used many types of metals with different characteristics under different RH and temperature conditions. While some metals were unaffected by high RH, others, like zinc and stainless steel, did acquire charge, when RH was >60%, and charged a capacitor to a voltage of 1 V. For the first time, we also performed outdoors experiments, showing this phenomenon is also valid under similar natural ambient humid conditions. If these results can be scaled up, it may lead to the development of practical applications for regions and times of high RH conditions.
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BACKGROUND: Hearing loss affects over 1.3 billion individuals worldwide, with the greatest burden among adults. Little is known regarding the association between adult-onset hearing loss and employment. METHODS: Seven databases (PubMed, Embase, Cochrane Library, ABI/Inform Collection, Business Source Ultimate, Web of Science and Scopus) were searched through to October 2018. The key word terms used related to hearing loss and employment, excluding paediatric or congenital hearing loss and deaf or culturally deaf populations. RESULTS: The initial search resulted in 13 144 articles. A total of 7494 articles underwent title and abstract screening, and 243 underwent full-text review. Twenty-five articles met the inclusion criteria. Studies were set in 10 predominantly high-income countries. Seven of the 25 studies analysed regionally or nationally representative datasets and controlled for key variables. Six of these seven studies reported associations between hearing loss and employment. CONCLUSION: The highest quality studies currently available indicate that adult-onset hearing loss is associated with unemployment. However, considerable heterogeneity exists, and more rigorous studies that include low- and middle-income countries are needed.
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Costo de Enfermedad , Empleo/estadística & datos numéricos , Pérdida Auditiva/complicaciones , Adulto , Anciano , Anciano de 80 o más Años , Empleo/economía , Pérdida Auditiva/economía , Humanos , Persona de Mediana Edad , Pensiones/estadística & datos numéricos , Personas con Deficiencia Auditiva/estadística & datos numéricos , Desempleo/estadística & datos numéricosRESUMEN
BACKGROUND AND PURPOSE: Although clinical trials suggest that colchicine may reduce the risk of vascular events in patients with a history of coronary artery disease, its effect on the prevention of cerebrovascular events still remains unclear. METHODS: A systematic review and meta-analysis was performed of all available randomized controlled trials (RCTs) reporting on incident strokes during the follow-up of patients with a history of cardiovascular disease randomized to colchicine treatment or control (placebo or usual care). RESULTS: Four RCTs were identified, including a total of 5553 patients (mean age 61 years, 81% males), with a follow-up ranging from 1 to 36 months. Colchicine treatment was associated with a significantly lower risk of incident stroke during follow-up compared to control (risk ratio 0.31, 95% confidence interval 0.13-0.71), without heterogeneity across included studies (I2 = 0%). Based on the pooled incident stroke rate of control groups (0.9%) in the included RCTs, it was estimated that administration of low-dose colchicine to 161 patients with coronary artery disease would prevent one stroke during a follow-up of 23 months. CONCLUSION: Colchicine treatment decreases stroke risk in patients with a history of coronary artery disease. The effect of colchicine in secondary stroke prevention is currently being evaluated in an ongoing RCT.
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Enfermedad de la Arteria Coronaria , Colchicina/uso terapéutico , Enfermedad de la Arteria Coronaria/complicaciones , Enfermedad de la Arteria Coronaria/tratamiento farmacológico , Enfermedad de la Arteria Coronaria/prevención & control , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevención Secundaria , Accidente Cerebrovascular/epidemiología , Accidente Cerebrovascular/prevención & controlRESUMEN
BACKGROUND: Active warming during surgery prevents perioperative hypothermia but the effectiveness and postoperative infection rates may differ between warming technologies. AIM: To establish the recruitment and data management strategies needed for a full trial comparing postoperative infection rates associated with forced air warming (FAW) versus resistive fabric warming (RFW) in patients aged >65 years undergoing hemiarthroplasty following fractured neck of femur. METHODS: Participants were randomized 1:1 in permuted blocks to FAW or RFW. Hypothermia was defined as a temperature of <36°C at the end of surgery. Primary outcomes were the number of participants recruited and the number with definitive deep surgical site infections. FINDINGS: A total of 515 participants were randomized at six sites over a period of 18 months. Follow-up was completed for 70.1%. Thirty-seven participants were hypothermic (7.5% in the FAW group; 9.7% in the RFW group). The mean temperatures before anaesthesia and at the end of surgery were similar. For the primary clinical outcome, there were four deep surgical site infections in the FAW group and three in the RFW group. All participants who developed a postoperative infection had antibiotic prophylaxis, a cemented prosthesis, and were operated under laminar airflow; none was hypothermic. There were no serious adverse events related to warming. CONCLUSION: Surgical site infections were identified in both groups. Progression from the pilot to the full trial is possible but will need to take account of the high attrition rate.
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Calefacción/métodos , Hemiartroplastia/métodos , Hipotermia/prevención & control , Infección de la Herida Quirúrgica/prevención & control , Anciano , Anciano de 80 o más Años , Femenino , Fracturas Óseas/cirugía , Humanos , Masculino , Resultado del TratamientoRESUMEN
We explore the understudied role of program staff in an out-of-school time (OST) program at a large science museum, which may be especially relevant for supporting underrepresented minority (URM) youth's interest in science, technology, engineering, or math (STEM) careers. Using a sequential explanatory mixed-method design, we surveyed 167 program alumni on their science attitudes, career interests, and memories about how the program compared to experiences at home, school, and with friends. We followed that with 49 interviews with alumni. Findings show that, while in the program, alumni who identify as women reported a much greater increase in their STEM career interest than those who identify as men. Interviews suggest this may be related to different types of staff relationships between the genders. We interpret results through the lens of positive youth development and offer recommendations for OST program providers and researchers.
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The Schumann Resonances (ScR) are Extremely Low Frequency (ELF) electromagnetic resonances in the Earth-ionosphere cavity excited by global lightning discharges. This natural electromagnetic noise has likely existed on the Earth ever since the Earth had an atmosphere and an ionosphere, hence surrounding us throughout our evolutionary history. The purpose of this study was to examine the influence of extremely weak magnetic fields in the ScR first mode frequency range on the spontaneous contractions, calcium transients and Creatine Kinase (CK) release of rat cardiac cell cultures. We show that applying 7.8 Hz, 90 nT magnetic fields (MF) causes a gradual decrease in the spontaneous calcium transients' amplitude, reaching 28% of the initial amplitude after 40 minutes of MF application, and accompanied with a gradual decrease in the calcium transients' rise time. The mechanical spontaneous contractions cease after the ScR fields have been applied for more than 30 minutes, when the calcium transient's amplitude reached ~60% of its initial value. The influence of the ScR MF was reversible, independent of the field magnitude in the range 20 pT-100 nT, and independent of the external DC magnetic field. However, the effect is frequency dependent; the described changes occurred only in the 7.6-8 Hz range. In addition, applying 7.8 Hz, 90 nT MF for 1.5 hours, reduced the amount of CK released to the buffer, during normal conditions, hypoxic conditions and oxidative stress induced by 80 µM H2O2. We show that the ScR field induced reduction in CK release is associated with a stress response process and has a protective character.
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Cardiotónicos , Creatina Quinasa/metabolismo , Campos Electromagnéticos , Miocitos Cardíacos/citología , Estrés Oxidativo , Animales , Ratas , Ratas Sprague-DawleyRESUMEN
In cattle and other species, the fetal ovary is steroidogenically active before follicular development commences, and there is evidence that estradiol and progesterone inhibit follicle formation and activation. Estradiol levels decline sharply around the time of follicle formation. In the present study, we hypothesized that FGF10 and FGF18, which inhibit estradiol secretion from granulosa cells of antral follicles, also regulate fetal ovarian steroid production. Fetuses were collected at local abattoirs, and age determined by crown-rump length measurements. Real-time polymerase chain reaction assays with RNA extracted from whole ovaries revealed that the abundance of CYP19A1 messenger RNA (mRNA) decreased from 60 to 90 days of gestation, which is consistent with the decline in estradiol secretion previously observed. Immunohistochemistry revealed the presence of FGF18 in ovigerous cords in early gestation and in oocytes later in fetal age (≥150 days). The abundance of FGF18 mRNA increased after Day 90 gestation. Addition of recombinant FGF18 to fetal ovarian pieces inhibited estradiol and progesterone secretion in vitro, whereas FGF10 was without effect. Consistent with these results, FGF18 decreased levels of mRNA for CYP19A1 and CYP11A1 in ovarian pieces in vitro. These data suggest that FGF18 may be an intraovarian factor that regulates steroidogenesis in fetal ovaries.
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Estradiol/biosíntesis , Feto/metabolismo , Factores de Crecimiento de Fibroblastos/biosíntesis , Células de la Granulosa/metabolismo , Progesterona/biosíntesis , Animales , Bovinos , Femenino , Feto/citología , Edad Gestacional , Células de la Granulosa/citologíaRESUMEN
Janus particles with an anisotropic structure have emerged as a focus of intensive research due to their diverse composition and surface chemistry, which show excellent performance in various fields, especially in biomedical applications. In this review, we briefly introduce the structures, composition, and properties of Janus particles, followed by a summary of their biomedical applications. Then we review several design strategies including morphology, particle size, composition, and surface modification, that will affect the performance of Janus particles. Subsequently, we explore the synthetic methodologies of Janus particles, with an emphasis on the most prevalent synthetic method (surface nucleation and seeded growth). Following this, we highlight Janus particles in biomedical applications, especially in drug delivery, bio-imaging, and bio-sensing. Finally, we will consider the current challenges the materials face with perspectives in the future directions.
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The Canadian dairy industry has been using invivo and invitro assisted reproductive technologies to produce embryos. Technological improvements have helped increase the number and quality of embryos produced, but genetic and genomic tools for improving these traits have yet to be assessed for the Canadian Holstein population. Genetic parameters and a genome-wide association study were performed in Canadian Holstein for the total number of embryos (NE) and the number of viable embryos (VE). Results showed potential for genetic selection for both NE and VE, with heritability estimates (± s.e.) of approximately 0.15±0.01. Genetic correlations between the number of embryos produced using different procedures (invivo and invitro) suggested that a similar number of embryos should be expected from a donor regardless of the procedure used. A region on chromosome 11 of the bovine genome was found to be significantly associated with the number of embryos, indicating a potential regulatory role of this region on embryo production. Overall, these findings are of interest for the Canadian dairy industry because they provide useful information for breeders that are interested in producing embryos from the elite donors in their herds or in the population using assisted reproductive technologies.
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Cruzamiento/métodos , Bovinos/embriología , Industria Lechera/métodos , Embrión de Mamíferos/citología , Técnicas Genéticas/veterinaria , Técnicas Reproductivas Asistidas/veterinaria , Animales , Bovinos/genética , Clonación de Organismos/métodos , Clonación de Organismos/veterinaria , Industria Lechera/tendencias , Embrión de Mamíferos/fisiología , Femenino , Estudio de Asociación del Genoma Completo/veterinaria , Genómica/métodos , Genómica/tendencias , Selección GenéticaRESUMEN
The aim of this study was to determine the expression of fibroblast growth factor 22 (FGF22) in the bovine corpus luteum (CL) and to investigate the effects of in vivo total or partial cloprostenol-induced luteolysis on the mRNA abundance of FGF22 and its receptor, FGFR1B. Corpora lutea at different stages of development were then dissected from abattoir ovaries (nâ¯=â¯10/stage); a portion of the tissue samples was fixed in paraformaldehyde and the remaining samples were homogenized and subjected to total RNA extraction. To assess mRNA abundance of target genes during induced luteolysis, nineteen cows were synchronized and then randomly assigned to a Latin square design as follows: Control; 2 administrations of prostaglandin F2α (PGF2α, total luteolysis; 2â¯×â¯250⯵g of cloprostenol sodium) and 1/6PGF2α (partial luteolysis; 83.33⯵g of cloprostenol sodium). FGF22 and FGFR1B expression levels were measured by RT-qPCR, and FGF22 protein expression was detected by immunohistochemistry. In summary, FGF22 mRNA was detected at all stages of CL development, and FGF22 protein was also detected in luteal tissue. FGF22 mRNA expression was lower at stage IV than at stage III (Pâ¯<â¯0.05), and the same pattern was observed in luteal immunoreactivity. Furthermore, cloprostenol-induced luteolysis, both total and partial, increased FGFR1B mRNA abundance in luteal tissue (Pâ¯<â¯0.05), but did not affect FGF22 mRNA abundance. In conclusion, these data suggest a potential role for the FGF22-FGFR1B system during development and regression of bovine CL.
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Cuerpo Lúteo/efectos de los fármacos , Cuerpo Lúteo/fisiología , Factores de Crecimiento de Fibroblastos/metabolismo , Regulación de la Expresión Génica/efectos de los fármacos , Receptores de Factores de Crecimiento de Fibroblastos/metabolismo , Animales , Bovinos , Cloprostenol/farmacología , Femenino , Factores de Crecimiento de Fibroblastos/genética , Regulación de la Expresión Génica/fisiología , Luteolíticos/farmacología , ARN Mensajero/genética , ARN Mensajero/metabolismo , Receptores de Factores de Crecimiento de Fibroblastos/genética , Técnicas de Cultivo de TejidosRESUMEN
Laryngopharyngeal reflux (LPR) is a clinical entity diagnosed by history laryngoscopic findings that has a variable response to empiric proton-pump inhibitor (PPI) therapy. While the reflux finding score (RFS), an endoscopic scoring scheme, has been advanced as a measure of LPR, it has not been externally validated against symptom severity in practice. Extralaryngeal pharyngeal endoscopic findings may have diagnostic utility but remain underexplored. This study assesses the correlation between extralaryngeal findings and (1) 24-hour oropharyngeal pH & (2) PPI response in patients with suspected LPR. Subjects presented to a tertiary care center with laryngeal symptoms ≥1 month and reflux symptom index (RSI) ≥13. Following baseline questionnaires, laryngoscopy, and a 24-hour oropharyngeal pH probe study, subjects were prescribed 8-12 week omeprazole trials. Baseline endoscopic findings were scored in a blinded fashion using the RFS and extralaryngeal score criteria, summatively the 'ELS.' PPI response was defined as ≥50% improvement in RSI. Thirty-three subjects with flexible endoscopic recordings completed baseline and follow-up questionnaires. The cohort's baseline mean RSI was 23.0 ± 7.2 with a ΔRSI = 9.8 after PPI therapy. The baseline RFS score averaged 5.3 ± 2.7. 45% of our subjects was found to be PPI responsive. The Cohen's kappa for the ELS but not the RFS was significant. There were no significant differences between the RFS (P = 0.10) or ELS (P = 0.07) for PPI responders & nonresponders. Oropharyngeal pH measures did not correlate with the RFS or ELS. In conclusion, endoscopic scores of laryngeal and extralaryngeal findings did not predict PPI response or oropharyngeal acid exposure in suspected LPR.
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Reflujo Laringofaríngeo/tratamiento farmacológico , Reflujo Laringofaríngeo/patología , Laringoscopía , Inhibidores de la Bomba de Protones/uso terapéutico , Adulto , Monitorización del pH Esofágico , Esófago/química , Femenino , Glotis/patología , Humanos , Concentración de Iones de Hidrógeno , Laringe/patología , Masculino , Persona de Mediana Edad , Faringe/patología , Estudios Prospectivos , Resultado del TratamientoRESUMEN
Background: Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and Trichomonas vaginalis (TV) infections may increase the risk of vertical transmission of the human immunodeficiency virus (HIV). In resource-limited settings, symptomatic screening, and syndromic management of sexually transmitted infections (STIs) during pregnancy continue to be the standard of care. In the absence of diagnostic testing, asymptomatic infections in pregnant women go untreated. Objective: To describe the acceptability and feasibility of integrating diagnostic STI screening into first antenatal care visits for HIV-infected pregnant women. Methods: HIV-infected pregnant women were recruited during their first antenatal care visit from three antenatal care clinics in Tshwane District, South Africa, between June 2016 and October 2017. Self-collected vaginal swabs were used to screen for CT, NG, and TV with a diagnostic point-of-care (POC) nucleic acid amplification test. Those with STIs were provided treatment per South African national guidelines. Results: Of 442 eligible women, 430 (97.3%) agreed to participate and were tested. Of those with a positive STI test result (n = 173; 40.2%), 159 (91.9%) received same-day results and treatment; 100% of STI-infected women were treated within seven days. Conclusions: Integration of POC diagnostic STI screening into first-visit antenatal care services was feasible and highly acceptable for HIV-infected pregnant women.
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Infecciones por Chlamydia/epidemiología , Gonorrea/epidemiología , Infecciones por VIH/complicaciones , Pruebas en el Punto de Atención , Tricomoniasis/epidemiología , Adulto , Infecciones Asintomáticas , Infecciones por Chlamydia/diagnóstico , Estudios de Factibilidad , Femenino , Gonorrea/diagnóstico , Humanos , Aceptación de la Atención de Salud/estadística & datos numéricos , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico , Complicaciones Infecciosas del Embarazo/epidemiología , Atención Prenatal/métodos , Sudáfrica/epidemiología , Tricomoniasis/diagnósticoRESUMEN
ABSTRACT The medical records of 983 patients diagnosed with the human immunodeficiency virus (HIV) were reviewed, 501 of whom were female and 482 were male. The mean age was 42.1 years, the mean number of years since diagnosis of HIV was 7.4, and the average duration of highly active antiretroviral therapy (HAART) was 51.7 months. The mean CD4 count at diagnosis was 268.5 cells/μL, but the most recent CD4 count was 461 cells/μL, and 85.8% of the patients were on HAART. The mean CD4 count was lower in those with a glomerular filtration rate (GFR) of < 60 ml/minute/1.73m2 compared to those patients with only proteinuria and a GFR of > 60 ml/minute/1.73m2. In the sample population, 76.9% of the patients had chronic kidney disease stage 3, 7.7% were in stage 4 and 15.4% in stage 5. There were 3.1% of patients with persistent proteinuria. Hypertension and diabetes mellitus were co-morbidities.
RESUMEN Se revisaron las historias clínicas de 983 pacientes diagnosticados con el virus de la inmunodeficiencia humana (VIH), 501 de los cuales eran mujeres, y 482 hombres. La edad promedio fue de 42.1 años, el número promedio de años a partir del diagnóstico de VIH fue 7.4, y la duración promedio de la terapia antirretroviral altamente activa (TARAA) fue de 51.7 meses. El conteo de CD4 promedio en el momento del diagnóstico fue de 268.5 células/μl pero el más reciente conteo de CD4 fue de 461 células/μl y el 85.8% de los pacientes se encontraban bajo terapia TARAA. El conteo de CD4 promedio fue menor en aquellos pacientes con una tasa de filtrado glomerular (TFG) de < 60 ml/minuto/1.73 m2, en comparación con los pacientes que tenían sólo proteinuria y una TFG de > 60 ml/minute/1.73 m2. En la población de la muestra, el 76.9% de los pacientes tenía enfermedad renal crónica en etapa 3, el 7.7% estaba en la etapa 4, y el 15.4% en la etapa 5. Había 3.1% de pacientes con proteinuria persistente. La hipertensión y la diabetes mellitus fueron comorbilidades.
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Humanos , Masculino , Femenino , Adulto , Infecciones por VIH/epidemiología , Insuficiencia Renal Crónica/epidemiología , Prevalencia , Factores de Riesgo , Jamaica/epidemiologíaRESUMEN
Calories from any food have the potential to increase risk for obesity and cardiometabolic disease because all calories can directly contribute to positive energy balance and fat gain. However, various dietary components or patterns may promote obesity and cardiometabolic disease by additional mechanisms that are not mediated solely by caloric content. Researchers explored this topic at the 2017 CrossFit Foundation Academic Conference 'Diet and Cardiometabolic Health - Beyond Calories', and this paper summarizes the presentations and follow-up discussions. Regarding the health effects of dietary fat, sugar and non-nutritive sweeteners, it is concluded that food-specific saturated fatty acids and sugar-sweetened beverages promote cardiometabolic diseases by mechanisms that are additional to their contribution of calories to positive energy balance and that aspartame does not promote weight gain. The challenges involved in conducting and interpreting clinical nutritional research, which preclude more extensive conclusions, are detailed. Emerging research is presented exploring the possibility that responses to certain dietary components/patterns are influenced by the metabolic status, developmental period or genotype of the individual; by the responsiveness of brain regions associated with reward to food cues; or by the microbiome. More research regarding these potential 'beyond calories' mechanisms may lead to new strategies for attenuating the obesity crisis.
Asunto(s)
Enfermedades Cardiovasculares/complicaciones , Dieta , Enfermedades Metabólicas/complicaciones , Enfermedades Cardiovasculares/metabolismo , Ingestión de Energía/fisiología , Humanos , Enfermedades Metabólicas/metabolismo , Valor Nutritivo , Aumento de Peso/fisiologíaRESUMEN
Superovulation or ovum pick-up and in vitro fertilization are technologies used to produce an increased number of embryos from elite females. Embryo production traits have been shown to be heritable, but the genes that cause this variability have not yet been assessed. The main objectives of this study were to perform a genome-wide association study (GWAS) to find single nucleotide polymorphisms (SNP) associated with embryo production traits and to identify candidate genes affecting the number of embryos produced by Holstein donors in Canada that may provide insight into the regulation of embryo production. Breeding values were estimated and de-regressed for all donors and sires using a data set of 150,971 records of superovulation or ovum pick-up and in vitro fertilization. A total of 11,607 animals were genotyped, but of that number only 5,118 were genotyped with at least a 50K SNP panel and had a de-regressed estimated breeding value reliability of at least 10%. For the GWAS, 606,406 imputed SNP on 29 autosomal chromosomes were considered after applying quality control measures. A single-SNP univariate mixed linear animal model was used to perform the GWAS, and a 5% false discovery rate was applied to adjust for multiple testing. We found 36 and 14 significant SNP associated with the total number of embryos and the number of viable embryos, respectively, with most of them located on chromosome 11. Using these significant SNP, positional genes located within 10,000 bp upstream and downstream of the SNP were retrieved. Thirteen genes were harboring or near the significant SNP for the total number of embryos, 4 of them also being near the significant SNP for viable embryos. Some of these genes (CRB2, DENND1A, MAD1L1, NDUFA8, PTGS1) could be considered as potential positional candidate genes related to the number of embryos produced by a donor. This list will need to be validated in an independent population to confirm the role of the genes for embryo production.