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1.
Nat Ecol Evol ; 2024 Sep 05.
Article in English | MEDLINE | ID: mdl-39237759

ABSTRACT

Urbanization is creating a new global biome, in which cities and suburbs around the world often resemble each other more than the local natural areas they replaced. But while urbanization can profoundly affect ecology at local scales, we know little about whether it disrupts large-scale ecological patterns. Here we test whether urbanization disrupts a macroecological pattern central to ecological and evolutionary theory: the increase in seed predation intensity from high to low latitudes. Across 14,000 km of latitude spanning the Americas, we compared predation intensity on two species of standardized experimental seeds in urbanized and natural areas. In natural areas, predation on both seed species increased fivefold from high latitudes to the tropics, one of the strongest latitudinal gradients in species interactions documented so far. Surprisingly, latitudinal gradients in predation were equally strong in urbanized areas despite significant habitat modification. Nevertheless, urbanization did affect seed predation. Compared with natural areas, urbanization reduced overall predation and vertebrate predation, did not affect predation by invertebrates in general, and increased predation by ants. Our results show that macroecological patterns in predation intensity can persist in urbanized environments, even as urbanization alters the relative importance of predators and potentially the evolutionary trajectory of urban populations.

2.
Obstet Gynecol Clin North Am ; 51(3): 453-461, 2024 Sep.
Article in English | MEDLINE | ID: mdl-39098772

ABSTRACT

Obstetrics and gynecologic hospitalists play a pivotal role in the evolution of perinatal care. Hospitalists improve patient safety by providing on-site, reliable, high-quality care. Hospitalists help to reduce the rates of unnecessary cesarean deliveries and increase the rates of vaginal deliveries.


Subject(s)
Gynecology , Hospitalists , Obstetrics , Patient Safety , Humans , Female , Pregnancy , Obstetrics/standards , Quality of Health Care , Perinatal Care/standards , Delivery, Obstetric/standards , Cesarean Section/statistics & numerical data
3.
Clin Auton Res ; 33(6): 623-633, 2023 12.
Article in English | MEDLINE | ID: mdl-37598402

ABSTRACT

PURPOSES: Habitual coffee drinking is ubiquitous and generally considered to be safe despite its transient hypertensive effect. Our purpose was to determine the role of the sympathetic nervous system in the hypertensive response. METHODS: In a single-centre crossover study, medical caregivers were studied after consumption of standard coffee (espresso), water and decaffeinated coffee (decaff) given in random order at least 1 month apart. Plasma caffeine levels, mean arterial pressure, heart rate, total peripheral resistance and muscle sympathetic activity were recorded. Baroreflex activity was assessed using burst incidence and RR interval changes to spontaneous blood pressure fluctuations. RESULTS: A total of 16 subjects (mean [± standard error] age 34.4 ± 2 years; 44% female) were recruited to the study. Three agents were studied in ten subjects, and two agents were studied in six subjects. Over a 120-min period following the consumption of standard coffee, mean (± SE) plasma caffeine levels increased from 2.4 ± 0.8 to 21.0 ± 4 µmol/L and arterial pressure increased to 103 ± 1 mmHg compared to water (101 ± 1 mmHg; p = 0.066) and decaff (100 ± 1 mmHg; p = 0.016). Peripheral resistance in the same period following coffee increased to 120 ± 4% of the baseline level compared to water (107 ± 4; p = 0.01) and decaff (109 ± 4; p = 0.02). Heart rate was lower after both coffee and decaff consumption: 62 ± 1 bpm compared to water (64 bpm; p = 0.01 and p = 0.02, respectively). Cardio-vagal baroreflex activity remained stable after coffee, but sympathetic activity decreased, with burst frequency of 96 ± 3% versus water (106 ± 3%; p = 0.04) and decaff (112 ± 3%; p = 0.001) despite a fall in baroreflex activity from - 2.2 ± 0.1 to - 1.8 ± 0.1 bursts/100 beats/mmHg, compared to water (p = 0.009) and decaff (p = 0.004). CONCLUSION: The hypertensive response to coffee is secondary to peripheral vasoconstriction but this is not mediated by increased sympathetic nerve activity. These results may explain why habitual coffee drinking is safe.


Subject(s)
Caffeine , Hypertension , Humans , Female , Adult , Male , Caffeine/pharmacology , Coffee , Cross-Over Studies , Blood Pressure/physiology , Sympathetic Nervous System , Baroreflex/physiology , Heart Rate , Water/pharmacology
4.
Int J Lang Commun Disord ; 58(5): 1539-1550, 2023.
Article in English | MEDLINE | ID: mdl-37070211

ABSTRACT

BACKGROUND: Speech and language therapists (SLTs) provide interventions for inducible laryngeal obstruction (ILO) despite a current lack of evidence to inform intervention delivery. This study is the first step to develop an evidence-based intervention for ILO, using behaviour change theory and the Behaviour Change Technique Taxonomy version 1 (BCTTv1). Outcomes will inform the early development stage of a complex speech and language therapy intervention for ILO, enabling more precise reporting of ILO intervention studies, as per CONSORT guidelines. AIMS: (1) To identify whether the BCTTv1 is a useful tool for characterising speech and language therapy interventions for ILO, based on existing literature, current practice and patient interviews. (2) To identify key behaviour change techniques (BCT) used within existing complex speech and language therapy interventions for ILO METHODS AND PROCEDURES: A five-phase study was conducted: (1) a systematic literature search of six electronic databases (Medline, EMBASE, CINAHL (EBSCO), Scopus, Trip, Web of Science) and grey literature between 2008 and 2020; (2) observations of six speech and language therapy intervention sessions; (3) a semi-structured interview with an SLT to validate the observed BCTTs; (4) consensus from four national expert SLTs regarding application of synthesised BCTT data to their own experiences of ILO interventions; and (5) patient engagement to review and comment on findings. OUTCOMES AND RESULTS: Forty-seven BCTs in total were coded across all three sources. Thirty-two BCTs were identified in clinical observations; 31 in interviews with SLTs and 18 in the literature. Only six BCT were identified in all three sources. Expert SLTs confirmed clinical application and relevance. Patients reported finding the concept of BCT challenging but highlighted the value of psychoeducation to support their understanding of symptoms and in turn to understand the rationale behind speech and language therapy intervention recommendations. CONCLUSION: This study indicates that the BCTTv1 is a suitable framework to identify and describe intervention components used within speech and language therapy interventions for ILO. A practice-research gap exists, reinforcing that existing literature does not capture the complexity of speech and language therapy intervention for ILO. Further research is needed to develop our understanding of the BCTs that support optimal behaviour change for this patient group. WHAT THIS PAPER ADDS: What is already known on the subject There is growing recognition for the value of speech and language therapists (SLTs) in delivering complex interventions for patients with inducible laryngeal obstruction (ILO), including evidence to suggest that their intervention can improve quality of life for patients and reduce excessive healthcare use. There are, however, no randomised controlled trials in this field; thus it is unclear what constitutes the most effective intervention. What this study adds This study demonstrates the complexity of speech and language therapy interventions for ILO and highlights the practice-research gap. It identifies a range of behaviour change techniques that are used in existing practice and captures patient views relating to the components identified within this study. What are the clinical implications of this work? Findings highlight the value of providing education about factors that might be driving ILO symptoms and in turn the importance of sharing with patients the rationale for treatment recommendations that necessitate a change in their behaviours. Identified behaviour change techniques can be used when developing and implementing SLT interventions for ILO.


Subject(s)
Language Therapy , Quality of Life , Humans , Language Therapy/methods , Speech , Speech Therapy/methods , Behavior Therapy/methods
5.
Am Surg ; 89(8): 3406-3410, 2023 Aug.
Article in English | MEDLINE | ID: mdl-36894880

ABSTRACT

INTRODUCTION: Stop the Bleed (STB), and other trainings that promote health education in basic trauma management techniques, is offered mostly in English and Spanish in the United States. Limited access to injury prevention training may contribute to inequities in health outcomes for individuals with limited English proficiency (LEP). Our study aims to determine the feasibility and effectiveness of STB training in 4 languages spoken in a super diverse refugee settlement community, Clarkston, GA. METHODS: Written STB educational materials were culturally adapted, translated, and back translated into 4 languages: Arabic, Burmese, Somali, and Swahili. Four 90-minute in-person STB trainings were conducted by medical personnel with community-based interpreters at a central and familiar location in the Clarkston community. Pre- and post-tests were administered in participant's preferred language to evaluate change in knowledge and beliefs as well as the effectiveness of the training method. RESULTS: A total of 46 community members were trained in STB, the majority of which were women (63%). Participants demonstrated improvement in their knowledge, confidence, and comfort using STB techniques. Participants reported that 2 aspects of the training were particularly beneficial: the presence of language concordant interpreters from the community and small group hands on sessions that allowed for practicing STB techniques. CONCLUSION: Cultural and linguistic adaptation of STB training is a feasible, cost-effective, and effective method for disseminating life-saving information and trauma education to immigrant populations who have LEP. Expansion of community training and partnerships to support the needs of diverse communities is both necessary and urgent.


Subject(s)
Health Promotion , Refugees , Humans , Male , Female , United States , Hemorrhage/prevention & control , Language , Linguistics
6.
Sci Rep ; 13(1): 4298, 2023 03 15.
Article in English | MEDLINE | ID: mdl-36922620

ABSTRACT

Although the use of airborne molecules as infochemicals is common in terrestrial plants, it has not been shown to occur in an ecologically relevant context in marine seaweeds. Like terrestrial plants, intertidal plants spend part of their lives emersed at low tide and release volatile organic compounds (VOCs) into the air when they are grazed or physiologically stressed. We hypothesized seaweeds could use airborne VOCs as infochemicals and respond to them by upregulating a keystone defensive metabolite, dimethylsulfoniopropionate (DMSP). We conducted laboratory and field experiments in which Ulva fenestrata was exposed to airborne dimethyl sulfide (DMS), a volatile antiherbivore and antioxidant metabolite released when the seaweed is grazed or physiologically stressed. In the laboratory, U. fenestrata exposed to DMS had 43-48% higher DMSP concentrations, relative to controls, 6-9 days after exposure. In the field, U. fenestrata 1 m downwind of DMS emitters had 19% higher DMSP concentrations than upwind seaweeds after 11 days. To our knowledge, this is the first demonstration of a marine plant using an airborne molecule released when damaged to elicit defensive responses. Our study suggests that the ability to detect airborne compounds has evolved multiple times or before the divergence of terrestrial plants and green algae.


Subject(s)
Chlorophyta , Sulfonium Compounds , Ulva , Ulva/metabolism , Cues , Sulfides/chemistry , Sulfonium Compounds/metabolism , Chlorophyta/metabolism
7.
BMJ Glob Health ; 8(2)2023 02.
Article in English | MEDLINE | ID: mdl-36750273

ABSTRACT

INTRODUCTION: Reducing unmet need for modern contraception and expanding access to quality maternal health (MH) services are priorities for improving women's health and economic empowerment. To support investment decisions, we estimated the additional cost and expected health and economic benefits of achieving the United Nations targets of zero unmet need for modern contraceptive choices and 95% coverage of MH services by 2030 in select Small Island Developing States. METHODS: Five Pacific (Kiribati, Samoa, Solomon Islands, Tonga and Vanuatu) and four Caribbean (Barbados, Guyana, Jamaica and Saint Lucia) countries were considered based on population survey data availability. For each country, the Lives Saved Tool was used to model costs, health outcomes and economic benefits for two scenarios: business-as-usual (BAU) (coverage maintained) and coverage-targets-achieved, which scaled linearly from 2022 (following COVID-19 disruptions) coverage of evidence-based family planning and MH interventions to reach United Nations targets, including modern contraceptive methods and access to complete antenatal, delivery and emergency care. Unintended pregnancies, maternal deaths, stillbirths and newborn deaths averted by the coverage-targets-achieved scenario were converted to workforce, education and social economic benefits; and benefit-cost ratios were calculated. RESULTS: The coverage-targets-achieved scenario required an additional US$12.6M (US$10.8M-US$15.9M) over 2020-2030 for the five Pacific countries (15% more than US$82.4M to maintain BAU). This additional investment was estimated to avert 126 000 (40%) unintended pregnancies, 2200 (28%) stillbirths and 121 (29%) maternal deaths and lead to a 15-fold economic benefit of US$190.6M (US$67.0M-US$304.5M) by 2050. For the four Caribbean countries, an additional US$17.8M (US$15.3M-US$22.4M) was needed to reach the targets (4% more than US$405.4M to maintain BAU). This was estimated to avert 127 000 (23%) unintended pregnancies, 3600 (23%) stillbirths and 221 (25%) maternal deaths and lead to a 24-fold economic benefit of US$426.2M (US$138.6M-US$745.7M) by 2050. CONCLUSION: Achieving full coverage of contraceptive and MH services in the Pacific and Caribbean is likely to have a high return on investment.


Subject(s)
COVID-19 , Maternal Death , Infant, Newborn , Female , Pregnancy , Humans , Contraceptive Agents , Stillbirth/epidemiology , Maternal Health , Caribbean Region
8.
J Patient Saf ; 19(3): 202-210, 2023 04 01.
Article in English | MEDLINE | ID: mdl-36630491

ABSTRACT

OBJECTIVES: This study aimed to evaluate the prevalence of obstetric and gynecologic (Ob/Gyn) hospitalists and determine if an association exists between the presence of Ob/Gyn hospitalists and severe maternal morbidity (SMM). METHODS: This observational study included data from hospitals listed in the USA TODAY 's 2019 article titled, "Deadly deliveries: Childbirth complication rates at maternity hospitals." Telephone and email surveys of staff in these hospitals identified the presence or absence of continuous providers in the hospital 24 hours, 7 days a week (24/7 coverage) and the types of providers who are employed, then compared these responses with the SMM cited by USA TODAY . RESULTS: Eight hundred ten hospitals were contacted, with participation from 614 labor and delivery units for a response rate of 75.8%. Fifty-seven percent of units were staffed with 24/7 coverage, with 46% of hospitals' coverage primarily provided by an Ob/Gyn hospitalist and 54% primarily by a nonhospitalist OB/Gyn provider. The SMM and presence of 24/7 coverage increased with the level of neonatal care and delivery volume. Of hospitals with 24/7 coverage, those that primarily used Ob/Gyn hospitalists had a lower SMM for all mothers (1.7 versus 2.0, P = 0.014) and for low-income mothers (1.9 versus 2.30, P = 0.007) than those who primarily used nonhospitalist OB/Gyn providers. CONCLUSIONS: Severe maternal morbidity increases with delivery volume, level of neonatal care, and 24/7 coverage. Of hospitals with 24/7 coverage, units that staff with Ob/Gyn hospitalists have lower levels of SMM than those that use nonhospitalist Ob/Gyn providers.


Subject(s)
Gynecology , Hospitalists , Obstetrics , Infant, Newborn , Female , Pregnancy , Humans , United States/epidemiology , Hospitals
9.
Int. arch. otorhinolaryngol. (Impr.) ; 26(3): 446-452, July-Sept. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1405131

ABSTRACT

Abstract Introduction Sinonasal melanomas are rare tumors with no comparative survival studies between Europe and the US. Objective To provide a population-based survival analysis between the two continents. Methods The European Cancer Registry (EUROCARE) and the United States Surveillance, Epidemiology, and End Results (SEER) databases were queried to identify patients diagnosed with sinonasal melanoma between 2000 and 2007. Relative survival (RS) data were grouped by age, gender, geographic region, extent of disease, and treatment modality. Results A total of 1,294 cases were identified between 2000 and 2007 (935 from EUROCARE-5 and 359 from SEER). Females were most commonly identified in Europe (56.4%) and in the US (54.9%). Patients over the age of 65 years comprised the greatest proportion of patients in Europe (70%) and in the US (71%). By region, Southern Europe had the highest 5-year RS (31.6%, 95% confidence interval [CI] = [21.3-42.5%]), and Eastern Europe the lowest (16.5%, [7.5-28.5%]). The aggregate European 5-year RS was 25.4% [21.8-29.1%] and the U.S. was (29.7%, [23.6-36%]). Conclusions Althoughincreasinginincidence, sinonasal melanomas remain rare. Women were more commonly affected. The most common age group was those older than 65 years, although age did not confer a prognostic value. The most common subsite was the nasalcavity followedbythe maxillarysinus.Five-yearRSwas similar betweencontinents withaninverse relationship between extentofdiseaseand survival. The treatment of choice throughout Europe and the US remains primarily surgical.

10.
Int Arch Otorhinolaryngol ; 26(3): e446-e452, 2022 Jul.
Article in English | MEDLINE | ID: mdl-35846812

ABSTRACT

Introduction Sinonasal melanomas are rare tumors with no comparative survival studies between Europe and the US. Objective To provide a population-based survival analysis between the two continents. Methods The European Cancer Registry (EUROCARE) and the United States Surveillance, Epidemiology, and End Results (SEER) databases were queried to identify patients diagnosed with sinonasal melanoma between 2000 and 2007. Relative survival (RS) data were grouped by age, gender, geographic region, extent of disease, and treatment modality. Results A total of 1,294 cases were identified between 2000 and 2007 (935 from EUROCARE-5 and 359 from SEER). Females were most commonly identified in Europe (56.4%) and in the US (54.9%). Patients over the age of 65 years comprised the greatest proportion of patients in Europe (70%) and in the US (71%). By region, Southern Europe had the highest 5-year RS (31.6%, 95% confidence interval [CI] = [21.3-42.5%]), and Eastern Europe the lowest (16.5%, [7.5-28.5%]). The aggregate European 5-year RS was 25.4% [21.8-29.1%] and the U.S. was (29.7%, [23.6-36%]). Conclusions Although increasing in incidence, sinonasal melanomas remain rare. Women were more commonly affected. The most common age group was those older than 65 years, although age did not confer a prognostic value. The most common subsite was the nasal cavity followed by the maxillary sinus. Five-year RS was similar between continents with an inverse relationship between extent of disease and survival. The treatment of choice throughout Europe and the US remains primarily surgical.

11.
Ann Otol Rhinol Laryngol ; 131(12): 1346-1352, 2022 Dec.
Article in English | MEDLINE | ID: mdl-35016557

ABSTRACT

OBJECTIVE: Manual jet ventilation is a specialized oxygenation and ventilation technique that is not available in all facilities due to lack of technical familiarity and fear of complications. The objective is to review our center's 15 year experience with low pressure low frequency jet ventilation (LPLFJV). METHODS: Retrospective review of procedures utilizing LPLFJV from 2005 to 2019 were performed collecting patient demographic, surgery type and complications. Fisher exact test, Chi square, and t-test were used to determine statistical significance. RESULTS: Four hundred fifty-seven patients underwent a total of 891 microlaryngeal surgeries-279 cases for voice disorders, 179 for lesions, and 433 for airway stenosis. The peak jet pressure for all cases did not exceed 20 psi and average peak pressure for the last 100 procedures in this case series was 14.9 ± 4.6 psi. The average lowest oxygen saturation for all cases was 95% ± 0.6%. Brief intubation was required in 154 cases (17%). Surgical duration was significantly longer for cases requiring intubation P < .001. The need for intubation was not associated with smoking or cardiopulmonary disease, but was strongly associated with body mass index (BMI). Intubation rates were 7% for normal weight (BMI < 25, N = 216), 13% for overweight (BMI 25-30, N = 282), 24% for obese (BMI 30-40, N = 342), and 37% for morbidly obese (BMI > 40, N = 52) patients. Three patients developed respiratory distress in the recovery unit and 2 patients required intubation. CONCLUSION: LPLFJV assisted by intermittent endotracheal intubation is an exceedingly safe and effective intraoperative oxygenation and ventilationmodality for a broad variety of laryngeal procedure.


Subject(s)
High-Frequency Jet Ventilation , Obesity, Morbid , High-Frequency Jet Ventilation/adverse effects , High-Frequency Jet Ventilation/methods , Humans , Intubation, Intratracheal/adverse effects , Intubation, Intratracheal/methods , Respiration, Artificial , Retrospective Studies
12.
Dalton Trans ; 50(30): 10593-10607, 2021 Aug 04.
Article in English | MEDLINE | ID: mdl-34278398

ABSTRACT

Complexes trans,trans,trans-[Pt(N3)2(OH)(OCOR)(py)2] where py = pyridine and where OCOR = succinate (1); 4-oxo-4-propoxybutanoate (2) and N-methylisatoate (3) have been synthesized by derivation of trans,trans,trans-[Pt(OH)2(N3)2(py)2] (4) and characterised by NMR and EPR spectroscopy, ESI-MS and X-ray crystallography. Irradiation of 1-3 with green (517 nm) light initiated photoreduction to Pt(ii) and release of the axial ligands at a 3-fold faster rate than for 4. TD-DFT calculations showed dissociative transitions at longer wavelengths for 1 compared to 4. Complexes 1 and 2 showed greater photocytotoxicity than 4 when irradiated with 420 nm light (A2780 cell line IC50 values: 2.7 and 3.7 µM) and complex 2 was particularly active towards the cisplatin-resistant cell line A2780cis (IC50 3.7 µM). Unlike 4, complexes 1-3 were phototoxic under green light irradiation (517 nm), with minimal toxicity in the dark. A pKa(H2O) of 5.13 for the free carboxylate group was determined for 1, corresponding to an overall negative charge during biological experiments, which crucially, did not appear to impede cellular accumulation and photocytotoxicity.


Subject(s)
Ovarian Neoplasms , Cell Line, Tumor , Female , Humans , Organoplatinum Compounds
13.
Eur Heart J Case Rep ; 5(5): ytab183, 2021 May.
Article in English | MEDLINE | ID: mdl-34017937

ABSTRACT

BACKGROUND: Hyponatraemia is a common problem in patients with heart failure. It can be difficult to treat, especially in the presence of the patient's needs for diuresis and manipulation of the renin-angiotensin-aldosterone system (RAAS). CASE SUMMARY: This concerns a 74-year-old woman with follicular lymphoma and severe global left ventricular systolic dysfunction secondary to treatment with R-CHOP chemotherapy. She presented a difficult challenge in the management of her decompensated heart failure alongside hyponatraemia as low as 113 mmol/L. This was resistant to standard treatment. The resistance to usual measures necessitated treatment with Tolvaptan, a selective arginine vasopressin V2 inhibitor used to treat hyponatraemia in syndrome of inappropriate anti-diuretic hormone. This, along with a strict fluid restriction of 500 mL/day, resolved the patient's hyponatraemia and enabled her discharge home on tolerated heart failure treatment. She has now remained stable for almost 12 months. DISCUSSION: The potential causes of hyponatraemia are discussed along with the role of Tolvaptan in its management.

14.
Ear Nose Throat J ; 100(1): NP1-NP6, 2021 Jan.
Article in English | MEDLINE | ID: mdl-31370682

ABSTRACT

Although the image quality from modern distal chip endoscopes is superior, limited mobility of the endoscopic tower prevents this technology from being used in inpatient and emergency departments. In these settings, otolaryngologists commonly use older flexible laryngoscopes with portable light sources. However, these light sources could malfunction. Smartphones are ubiquitous nowadays, and the smartphone's flashlight may be used alternatively to provide illumination when primary light malfunctions. This study compares the ability of flashlights from various smartphone models in providing adequate illumination for flexible laryngoscopy when compared to a commercially available portable light source. White wall and mucosal images were captured using Olympus P4 flexible scope and lights from the Stryker X8000 endoscopy tower light source, Storz 11301D3 portable light source (control), iPhone 4, iPhone 6, iPhone 8, iPhone X, Galaxy S6, and Galaxy S7. ImageJ was used to quantify pixel intensities with white and black standardized as 250 and 0, respectively. Student 2-tailed t test was used for analysis. The endoscopic tower outperformed all other light sources in all categories. The iPhone 4 and iPhone 6 consistently underperformed in comparison to the Storz 11301D3 portable light source (P < .05). Galaxy S6, Galaxy S7, and newer generation iPhone 8 and iPhone X provide comparable pixel intensities to Storz 11301D3 portable light. Smartphones incorporate different types of light-emitting diodes. Newer Galaxy and iPhone provide adequate illumination for the endoscopic assessment of the airway when compared to commercially available portable light source. However, one should always utilize the best commercially available light source in nonemergent cases.


Subject(s)
Endoscopy/instrumentation , Laryngoscopy/instrumentation , Lighting/instrumentation , Smartphone , Emergencies , Endoscopes , Feasibility Studies , Humans , Laryngoscopes
15.
Intern Med J ; 50(12): 1563-1566, 2020 Dec.
Article in English | MEDLINE | ID: mdl-33354887

ABSTRACT

One hundred and ninety-four patient episodes were audited for response to a standardised 1 g intravenous iron infusion for medical outpatients with iron deficiency anaemia. Patients received either ferric carboxymaltose or iron polymaltose. At 5-7 weeks after infusion, mean increase in Hb was 26.7 g/L and ferritin was 161 mcg/L, and only one patient had Hb <100 g/L. This reassures that 1 g dose of intravenous iron is sufficient for most patients, with benefits for treatment costs and patient convenience.


Subject(s)
Anemia, Iron-Deficiency , Administration, Intravenous , Anemia, Iron-Deficiency/drug therapy , Ferric Compounds , Ferritins , Humans , Infusions, Intravenous , Iron
16.
Chem Commun (Camb) ; 54(98): 13845-13848, 2018 Dec 06.
Article in English | MEDLINE | ID: mdl-30468213

ABSTRACT

l-Tryptophan (Trp), melatonin (MLT) and the Trp-peptide pentagastrin quenched the formation of azidyl radicals generated on irradiation of the anticancer complex trans,trans,trans-[Pt(pyridine)2(N3)2(OH)2] with visible light, giving rise to C3-centred indole radicals which were characterized for Trp and MLT using an EPR spin-trap; indole, together with azidyl and hydroxyl radicals, have potential roles in a multitargeting mechanism of action against resistant cancers.


Subject(s)
Antineoplastic Agents/chemistry , Free Radicals/chemistry , Organoplatinum Compounds/chemistry , Photosensitizing Agents/chemistry , Pyridines/chemistry , Tryptophan/chemistry , Hydroxyl Radical/chemistry , Indoles/chemistry , Light , Melatonin/chemistry , Photochemical Processes
17.
J Biol Chem ; 293(13): 4666-4679, 2018 03 30.
Article in English | MEDLINE | ID: mdl-29602878

ABSTRACT

Klebsiella pneumoniae is a major health threat. Vaccination and passive immunization are considered as alternative therapeutic strategies for managing Klebsiella infections. Lipopolysaccharide O antigens are attractive candidates because of the relatively small range of known O-antigen polysaccharide structures, but immunotherapeutic applications require a complete understanding of the structures found in clinical settings. Currently, the precise number of Klebsiella O antigens is unknown because available serological tests have limited resolution, and their association with defined chemical structures is sometimes uncertain. Molecular serotyping methods can evaluate clinical prevalence of O serotypes but require a full understanding of the genetic determinants for each O-antigen structure. This is problematic with Klebsiella pneumoniae because genes outside the main rfb (O-antigen biosynthesis) locus can have profound effects on the final structure. Here, we report two new loci encoding enzymes that modify a conserved polysaccharide backbone comprising disaccharide repeat units [→3)-α-d-Galp-(1→3)-ß-d-Galf-(1→] (O2a antigen). We identified in serotype O2aeh a three-component system that modifies completed O2a glycan in the periplasm by adding 1,2-linked α-Galp side-group residues. In serotype O2ac, a polysaccharide comprising disaccharide repeat units [→5)-ß-d-Galf-(1→3)-ß-d-GlcpNAc-(1→] (O2c antigen) is attached to the non-reducing termini of O2a-antigen chains. O2c-polysaccharide synthesis is dependent on a locus encoding three glycosyltransferase enzymes. The authentic O2aeh and O2c antigens were recapitulated in recombinant Escherichia coli hosts to establish the essential gene set for their synthesis. These findings now provide a complete understanding of the molecular genetic basis for the known variations in Klebsiella O-antigen carbohydrate structures based on the O2a backbone.


Subject(s)
Bacterial Proteins , Klebsiella pneumoniae , O Antigens , Animals , Bacterial Proteins/biosynthesis , Bacterial Proteins/genetics , Carbohydrate Conformation , Klebsiella pneumoniae/chemistry , Klebsiella pneumoniae/genetics , Klebsiella pneumoniae/metabolism , O Antigens/biosynthesis , O Antigens/chemistry , O Antigens/genetics , Rabbits
18.
Psychol Sci ; 29(4): 549-571, 2018 04.
Article in English | MEDLINE | ID: mdl-29505339

ABSTRACT

Mind-sets (aka implicit theories) are beliefs about the nature of human attributes (e.g., intelligence). The theory holds that individuals with growth mind-sets (beliefs that attributes are malleable with effort) enjoy many positive outcomes-including higher academic achievement-while their peers who have fixed mind-sets experience negative outcomes. Given this relationship, interventions designed to increase students' growth mind-sets-thereby increasing their academic achievement-have been implemented in schools around the world. In our first meta-analysis ( k = 273, N = 365,915), we examined the strength of the relationship between mind-set and academic achievement and potential moderating factors. In our second meta-analysis ( k = 43, N = 57,155), we examined the effectiveness of mind-set interventions on academic achievement and potential moderating factors. Overall effects were weak for both meta-analyses. However, some results supported specific tenets of the theory, namely, that students with low socioeconomic status or who are academically at risk might benefit from mind-set interventions.


Subject(s)
Academic Success , Attitude , Intelligence , Students , Adolescent , Adult , Child , Female , Humans , Male , Self Concept , Young Adult
19.
Confl Health ; 11: 25, 2017.
Article in English | MEDLINE | ID: mdl-29213302

ABSTRACT

BACKGROUND: While the conditions in emergency humanitarian and conflict-affected settings often result in significant sex work economies, there is limited information on the social and structural conditions of sex work in these settings, and the impacts on HIV/STI prevention and access to sexual and reproductive health (SRH) services for sex workers. Our objective was to comprehensively review existing evidence on HIV/STI prevention and access to SRH services for sex workers in conflict-affected settings globally. METHODS: We conducted a comprehensive review of all peer review (both epidemiological and qualitative) and grey literature published in the last 15 years (2000-2015), focusing on 1) HIV/STI vulnerability or prevention, and/or 2) access to SRH services for sex workers in conflict-affected settings. Five databases were searched, using combinations of sex work, conflict/mobility, HIV/STI, and SRH service terms. Relevant peer-reviewed and grey literature were also hand-searched, and key papers were cross-referenced for additional material. RESULTS: Five hundred fifty one records were screened and 416 records reviewed. Of 33 records describing HIV/STI prevention and/or access to SRH services among sex workers in conflict-affected settings, 24 were from sub-Saharan Africa; 18 studies described the results of primary research (13 quantitative, 3 qualitative, 2 mixed-methods) and 15 were non-primary research (e.g., commentaries, policy reports, programmatic manuals). Available evidence indicated that within conflict-affected settings, SWs' capacity to engage in HIV/STI prevention and access SRH services is severely undermined by social and structural determinants including widespread violence and human rights violations, the collapse of livelihoods and traditional social structures, high levels of displacement, and difficulties accessing already scant health services due to stigma, discrimination and criminalization. DISCUSSION/CONCLUSIONS: This review identified significant gaps in HIV/STI and SRH research, policy, and programming for conflict-affected sex workers, highlighting a critical gap in the humanitarian response. Sex worker-informed policies and interventions to promote HIV/STI prevention and access to HIV and SRH services using a rights-based approach are recommended, and further research on the degree to which conflict-affected sex workers are accessing HIV/STI and SRH services is recommended.A paradigm shift from the behavioural and biomedical approach to a human rights-based approach to HIV/STI prevention and SRH is strongly recommended.

20.
J Inorg Biochem ; 175: 179-189, 2017 10.
Article in English | MEDLINE | ID: mdl-28756174

ABSTRACT

The lectin DLasiL was isolated from seeds of the Dioclea lasiocarpa collected from the northeast coast of Brazil and characterized for the first time by mass spectrometry, DNA sequencing, inductively coupled plasma-mass spectrometry, electron paramagnetic resonance, and fluorescence spectroscopy. The structure of DLasiL lectin obtained by homology modelling suggested strong conservation of the dinuclear Ca/Mn and sugar-binding sites, and dependence of the solvent accessibility of tryptophan-88 on the oligomerisation state of the protein. DLasiL showed highly potent (low nanomolar) antiproliferative activity against several human carcinoma cell lines including A2780 (ovarian), A549 (lung), MCF-7 (breast) and PC3 (prostate), and was as, or more, potent than the lectins ConBr (Canavalia brasiliensis), ConM (Canavalia maritima) and DSclerL (Dioclea sclerocarpa) against A2780 and PC3 cells. Interestingly, DLasiL lectin caused a G2/M arrest in A2780 cells after 24h exposure, activating caspase 9 and delaying the on-set of apoptosis. Confocal microscopy showed that fluorescently-labelled DLasiL localized around the nuclei of A2780 cells at lectin doses of 0.5-2× IC50 and gave rise to enlarged nuclei and spreading of the cells at high doses. These data reveal the interesting antiproliferative activity of DLasiL lectin, and suggest that further investigations to explore the potential of DLasiL as a new anticancer agent are warranted.


Subject(s)
Antineoplastic Agents, Phytogenic/pharmacology , Dioclea/chemistry , G2 Phase Cell Cycle Checkpoints/drug effects , M Phase Cell Cycle Checkpoints/drug effects , Neoplasms/drug therapy , Plant Lectins/pharmacology , A549 Cells , Antineoplastic Agents, Phytogenic/chemistry , Humans , MCF-7 Cells , Neoplasms/metabolism , Neoplasms/pathology , Plant Lectins/chemistry
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