RESUMEN
Different types of infant foods categorized as formulas, cereals, and purees imported from seven different countries and available on the Kuwaiti retail market were collected to determine the elemental content, including essential trace elements namely chromium (Cr), manganese (Mn), iron (Fe), copper (Cu), zinc (Zn), selenium (Se), and molybdenum (Mo); potentially toxic trace elements such as aluminum (Al), nickel (Ni), tin (Sn), antimony (Sb), and uranium (U); and toxic trace elements including arsenic (As), lead (Pb), cadmium (Cd), and mercury (Hg). The samples were analyzed using ICP-MS. An extensive literature search illustrated the uniqueness of this study since seven different essential elements, five different potentially toxic elements, and four different toxic trace elements were measured in a variety of infant foods; in addition, the different trace etlemental levels measured in the investigated infant foods were compared to the ones associated with the different infant foods types reported in the literature. The essential trace element concentrations detected in this study were implemented to calculate their total daily intake, where the calculated daily intake values were compared to their recommended dietary allowance (RDA) to assess the percentage total daily intake for the essential trace elements. Further, the calculated potentially toxic and toxic trace elements daily intake values were used to assess the potential health risks to infants incurred by consuming different infant foods by calculating the hazard quotient (HQ), while the margin of exposure (MOE) was calculated for the toxic ones only. It was concluded that infant formulas and foods should be added to the infant diet in addition to breast milk to meet specific nutritional needs. This study confirms that infants are exposed to toxic trace elements via diet, warranting careful attention to diet choices both to limit this exposure and to avert potentially hazardous adverse health effects to the infants. However, based on the calculated hazard quotients (HQs) and margin of exposures (MOEs), consuming breast milk in addition to almost all different types of infant foods is considered safe and unlikely to contribute to infants' non-cancerous health hazards.
Asunto(s)
Alimentos Infantiles , Oligoelementos , Humanos , Oligoelementos/análisis , Kuwait , Lactante , Alimentos Infantiles/análisis , Dieta , Exposición Dietética/análisisRESUMEN
Current evaluation of treatment response in solid tumors depends on dynamic changes in tumor diameters as measured by imaging. However, these changes can only be detected when there are enough macroscopic changes in tumor volume, which limits the usability of radiological response criteria in evaluating earlier stages of disease response and necessitates much time to lapse for gross changes to be notable. One promising approach is to incorporate dynamic changes in circulating tumor DNA (ctDNA), which occur early in the course of therapy and can predict tumor responses weeks before gross size changes manifest. However, several issues need to be addressed before recommending the implementation of ctDNA response criteria in daily clinical practice such as clinical, biological, and regulatory challenges and, most importantly, the need to standardize/harmonize detection methods and ways to define ctDNA response and/or progression for precision oncology. Herein, we review the use of liquid biopsy (LB) to evaluate response in solid tumors and propose a plan toward standardization of LB-RECIST.
Asunto(s)
ADN Tumoral Circulante , Neoplasias , Humanos , Neoplasias/diagnóstico por imagen , Neoplasias/genética , Criterios de Evaluación de Respuesta en Tumores Sólidos , Medicina de Precisión , Biopsia Líquida , ADN Tumoral Circulante/genética , Biomarcadores de Tumor/genéticaRESUMEN
We report a 60-year-old woman who presented to the emergency department after experiencing a witnessed unknown onset bilateral tonic clonic seizure (GTCS) that culminated in cardiac arrest. A neurology consultant uncovered a years-long history of frequent episodic staring followed by confusion and expressive aphasia, which strongly suggested that she suffered from epilepsy. Thus, her cardiac arrest and subsequent resuscitation met criteria for a near-sudden unexpected death in epilepsy (SUDEP) diagnosis. Serial bloodwork demonstrated transient troponin I elevations and leukocytoses, while a brain MRI revealed global cerebral anoxic injury and a small acute right cerebellar ischemic infarction. A review of her medical record uncovered a hospitalization sixteen months earlier for a likely GTCS whose workup showed similar troponin I elevations and leukocytoses, and surprisingly, a different small acute right cerebellar ischemic infarction in the same vascular territory. To our knowledge, this is the first report of subcortical ischemic infarctions occurring concurrently with GTCSs in a near-SUDEP patient. Aside from illustrating the key role of inpatient neurologists in the diagnosis of near-SUDEP, this manuscript discusses the potential significance of postictal ischemic infarctions, transient asymptomatic troponin elevations, and transient non-infectious leukocytoses in epilepsy patients with cardiovascular risk factors.
RESUMEN
Previously we had demonstrated the development and feasibility of an integrated chrono-nutrition weight reduction program among non-shift workers with morning and evening chronotypes. In this current paper, we described the association between the changes in chrono-nutrition practice and weight loss outcomes upon completing the weight reduction program. A total of 91 overweight/obese non-shift workers participated in the 12-week integrated chrono-nutrition weight reduction program (Age: 39.6 ± 6.3 y; 74.7% women; BMI: 31.2 ± 4.5 kg/m2). All the assessments including anthropometry, dietary, sleep habits, physical activity, and process of change were measured during pre- and post-intervention. Participants who had lost ≥3% of their body weight were categorized as satisfactory weight loss outcome, and those who did not achieve 3% weight loss were categorized as unsatisfactory weight loss. The satisfactory weight loss had greater daily percent energy intake during earlier in the day from protein (Mean difference (MD): +3.2%, 95% CI: 1.6, 4.9, p < .001) and smaller intake from fat during later in the day (MD: -2.6%, 95% CI: -5.1, -0.1, p = .045), earlier last mealtime (MD: -49.5 min, 95% CI: -86.5, -12.6, p = .009) and midpoint of eating (MD: -27.3 min, 95% CI: -46.3, -8.2, p = .006), shorter eating window (-0.8 h, 95% CI: -1.4, -0.1, p = .031) and greater reduction in night eating syndrome score (MD: -2.4, 95% CI: -4.3, -0.5, p = .015) compared to unsatisfactory weight loss outcome. After accounting for potential confounders, the temporal pattern of energy, protein, and fat intake were associated with greater odds of achieving a satisfactory weight loss. The findings suggest a promising role of chrono-nutrition as one of the strategies in weight reduction intervention.
Asunto(s)
Ritmo Circadiano , Conducta Alimentaria , Humanos , Femenino , Adulto , Persona de Mediana Edad , Masculino , Estudios de Factibilidad , Estado Nutricional , Ingestión de Energía , Pérdida de Peso , Índice de Masa CorporalRESUMEN
Purpose: To establish the safety, tolerability, pharmacokinetics, and pharmacodynamics of an intravitreal injection of recombinant human complement factor H (CFH), GEM103, in individuals with genetically defined age-related macular degeneration (AMD) and geographic atrophy (GA). Design: Phase I single ascending-dose, open-label clinical trial (ClinicalTrials.gov identifier, NCT04246866). Participants: Twelve individuals 50 years of age or older with a confirmed diagnosis of foveal GA in the study eye. Methods: Participants were assigned to the increasing dose cohorts and received 1 50-µl intravitreal injection of GEM103 at doses of 50 µg/eye, 100 µg/eye, 250 µg/eye, or 500 µg/eye; dose escalation was dependent on the occurrence of dose-limiting toxicities. Main Outcome Measures: Safety assessments included ocular and systemic adverse events (AEs), ocular examinations, clinical laboratory and vital signs, and serum antidrug antibody levels. Biomarkers, measured in the aqueous humor (AH), included CFH and complement activation biomarkers factor Ba and complement component 3a. Results: No dose-limiting toxicities were reported, enabling escalation to the maximum study dose. No anti-GEM103 antidrug antibodies were detected during the study. Four participants experienced AEs; these were nonserious, mild or moderate in severity, and unrelated to GEM103. The AEs in 2 of these participants were related to the intravitreal injection procedure. No clinically significant ophthalmic changes and no ocular inflammation were observed. Visual acuity was maintained and stable throughout the 8-week follow-up period. No choroidal neovascularization occurred. CFH levels increased in a dose-dependent manner after GEM103 administration with supraphysiological levels observed at week 1; levels were more than baseline for 8 weeks or more in all participants receiving single doses of 100 µg or more. Complement activation biomarkers were reduced 7 days after dose administration. Conclusions: A single intravitreal administration of GEM103 (up to 500 µg/eye) was well tolerated in individuals with GA. Of the few mild or moderate AEs reported, none were determined to be related to GEM103. No intraocular inflammation or choroidal neovascularization developed. CFH levels in AH were increased and stable for 8 weeks, with pharmacodynamic data suggesting that GEM103 restored complement regulation. These results support further development in a repeat-dose trial in patients with GA with AMD.
RESUMEN
Background: Hereditary tyrosinemia type 1 is a rare genetic disorder leading to liver cirrhosis and hepatocellular carcinoma. Few decades ago, dietary measures and ultimately liver transplant constituted the only treatment modalities. Nowadays, early diagnosis and therapy with nitisinone can reverse the clinical picture. In developing countries, diagnostic and therapeutic challenges may affect the outcome of this disease. The choice of the treatment modality may depend on the economic status of each country. Few reports on the long-term outcome of hereditary tyrosinemia type 1 are available from developing and Arab countries. Methods: A retrospective study of charts of Lebanese patients diagnosed with tyrosinemia type 1 and followed, at the American University of Beirut, during a 12-year period was performed. Clinical presentation and liver biochemical profile at diagnosis were analyzed, along with therapeutic modalities and long-term outcome. Results: Twenty-two children were diagnosed and followed during the study period. Median age at diagnosis was 7 months (range: one day to 35 months). Most of the patients presented with hepatomegaly and jaundice. Four patients were referred for atypical presentations with developmental delay and seizures, secondary to undiagnosed hypoglycemia episodes. Around half of the patients presented with failure to thrive. Transaminitis, cholestasis and increased α-fetoprotein level were variably present at diagnosis (36% to 50%). All patients had elevated plasma tyrosine and urinary succinylacetone levels. Genetic testing was performed in 9%. Only one third could be treated with nitisinone. Liver transplant was electively performed in 9% of cases, to overcome the long-term cost of nitisinone. One third of the patients died between the age of 1 month and 11 years. Surviving patients are still candidates for liver transplant. Conclusion: Our experience reflects the challenges of diagnosis and treatment of hereditary tyrosinemia type 1 in a developing country. In the absence of specific neonatal screening, early diagnosis relies mostly on the clinical awareness of the physician. Long-term nitisinone use may be deterred by its high cost and liver transplantation carries risks of surgical complications. New, effective, and less expensive treatments are needed, especially for developing countries.
RESUMEN
Introduction: The incidence of acute kidney injury (AKI) in pediatric patients following cardiac surgery varies between 15 and 64%, with a mortality rate of 10-89% among those requiring dialysis. This variation in the incidence and mortality of AKI across studies is probably due to the inconsistent definitions used for AKI. The purpose of this study is to present our experience with AKI post-cardiac surgery with emphasis on predisposing or aggravating factors. Patients and Methods: We evaluated the incidence of AKI using the KDIGO criteria in 150 infants and children undergoing cardiac surgeries between 2015 and 2017. Post-operatively, all patients were admitted to the pediatric intensive care unit (PICU) at a tertiary care center in a developing country. This is a retrospective chart review in which data collected included age, gender, type of heart disease, prior cardiac surgeries, RACHS-1 category, and pre- and post-operative creatinine levels. Neonates were not included in this study. Results: Six percent of the studied patients were below 1 year of age, 84% 1-10 years, and 10% 10-18 years. Fourteen patients (9.3%) developed AKI. Patients with cyanotic heart disease were more prone to develop AKI (78%) compared to those with non-cyanotic heart disease (44%). Children with AKI had a higher length of stay in PICU, 2.56 ± 1.44 vs. 4 ± 2.66 (p- 0.02). Serum lactic acid was higher in patients who developed AKI with a mean value of 6.8 ± 6.9 vs. 2.85 ± 1.55 mmol/l in the non-AKI group (p- 0.03). Lower hemoglobin levels and hyperlactic acidemia were significantly more prevalent in the AKI group. There were five deaths in this series (3.3%), and four of those (80%) were in the AKI group. Conclusion: Using the KDIGO criteria, the incidence of AKI in infants and children following cardiac surgery was 9.3%. This is slightly lower than in previously published studies where the range was between 15 and 64%. Children with cyanotic cardiac disease, hyperlactic acidemia, and anemia were more prone to developing AKI. Identifying patients at risk might help decrease the risk of post-operative AKI.
RESUMEN
We report on an 8-year-old boy, who presented to the emergency department at our institution with fever, generalised oedema and hypotension. Investigations revealed anaemia, thrombocytopenia in addition to elevated serum inflammatory markers, a negative COVID-19 PCR test and a positive COVID-19 IgG. His echocardiography was consistent with carditis in otherwise morphologically normal heart with depressed cardiac function, moderate-to-severe mitral valve regurgitation, moderate tricuspid regurgitation with an estimated right ventricular systolic pressure half systemic, trace aortic regurgitation, bilateral small pleural effusions, distended inferior vena cava and normal coronaries. He was started on inotropic support, intravenous immunoglobulin and methylprednisolone, and was transferred to the paediatric intensive care unit. To the best of our knowledge, this was the first case of multisystem inflammatory syndrome in children encountered in Lebanon. The presentation and management were thoroughly described in this article aiming to share our experience and to contribute to the rapidly emerging literature on this syndrome.
Asunto(s)
COVID-19 , Insuficiencia de la Válvula Mitral , Insuficiencia de la Válvula Tricúspide , Niño , Humanos , Líbano , Masculino , Insuficiencia de la Válvula Mitral/diagnóstico por imagen , Insuficiencia de la Válvula Mitral/etiología , SARS-CoV-2 , Síndrome de Respuesta Inflamatoria SistémicaRESUMEN
Platinum is the most commonly used catalyst in fuel cell application. However, platinum is very expensive, thus limits the commercialisation of fuel cell system due to the cost factor. This study introduces a biosynthesis platinum from plant extracts that can reduce the cost of platinum production compared to the conventional method and the hazardous during the production of the catalyst. The biogenic platinum was tested on a Direct Methanol Fuel Cell. Advanced biogenic of Pt nano-cluster was synthesized through a novel and facile of one-pot synthesis bio-reduction derived from natural source in the form of plant extracts as reducing agent. Several selected plant extracts drawn from agricultural waste such as banana peel, pineapple peels and sugarcane bagasse extracts were comparatively evaluated on the ability of phytochemical sources of polyphenols rich for the development of single-step synthesis for Pt NPs. Notably, the biogenic Pt NPs from sugar cane bagasse has superior electro-catalytic activity, the enhanced utilization efficiency of Pt and appreciable stability towards methanol oxidation reaction, whose ECSA value approximates 94.58 m2g-1, mass activity/specific activity (398.20 mAmg-1/0.8471 mA/cm2 Pt) which greater than commercial Pt black (158.12 mAmg-1/1.41 mA/cm2 Pt).
RESUMEN
BACKGROUND: Operating room planning is a complex task as pre-operative estimations of procedure duration have a limited accuracy. This is due to large variations in the course of procedures. Therefore, information about the progress of procedures is essential to adapt the daily operating room schedule accordingly. This information should ideally be objective, automatically retrievable and in real-time. Recordings made during endoscopic surgeries are a potential source of progress information. A trained observer is able to recognize the ongoing surgical phase from watching these videos. The introduction of deep learning techniques brought up opportunities to automatically retrieve information from surgical videos. The aim of this study was to apply state-of-the art deep learning techniques on a new set of endoscopic videos to automatically recognize the progress of a procedure, and to assess the feasibility of the approach in terms of performance, scalability and practical considerations. METHODS: A dataset of 33 laparoscopic cholecystectomies (LC) and 35 total laparoscopic hysterectomies (TLH) was used. The surgical tools that were used and the ongoing surgical phases were annotated in the recordings. Neural networks were trained on a subset of annotated videos. The automatic recognition of surgical tools and phases was then assessed on another subset. The scalability of the networks was tested and practical considerations were kept up. RESULTS: The performance of the surgical tools and phase recognition reached an average precision and recall between 0.77 and 0.89. The scalability tests showed diverging results. Legal considerations had to be taken into account and a considerable amount of time was needed to annotate the datasets. CONCLUSION: This study shows the potential of deep learning to automatically recognize information contained in surgical videos. This study also provides insights in the applicability of such a technique to support operating room planning.
Asunto(s)
Colecistectomía Laparoscópica , Aprendizaje Profundo , Laparoscopía , Humanos , Redes Neurales de la ComputaciónRESUMEN
The paper reports on the importance of applying the holistic approach in designing a personalized bone scaffold, but also all other kinds of personalized implants. In addition, the paper attempts to point out the important aspects of the design of a PBS against which the quality of a realistic and applicable design solution should be assessed. The holistic approach refers to the adaptation of design features of a bone scaffold to the multilateral specifics related to the particular patient, its surgical case, and curing treatment. To ensure a successful application, five aspects of personalized bone scaffold design should be considered while it is being adapted: anatomical congruency, mechanical conformity, biochemical compatibility and biodegradability, manufacturability, and implantability. To demonstrate the importance of applying a holistic approach in designing a personalized bone scaffold, the paper shows a case where a patient-specific scaffold aimed at the reconstruction of a large missing piece of mandible was designed. The research resulted in a series of recommendations regarding the methods of bone geometry reconstruction and scaffold design. The paper sheds new light on the desired mechanical properties of a personalized bone scaffold while also recommending possible design parameters for optimizing the construction according to these properties. Finally, it recommends a possible procedure of integral production of personalized bone scaffold and bone graft. The presented so-called holistic approach announces a new systematic process of designing a personalized bone scaffold, which, although requiring a comprehensive consideration of complex requirements, is inevitable to make the designed solution applicable.
Asunto(s)
Mandíbula , Procedimientos de Cirugía Plástica , Trasplante Óseo , Humanos , Mandíbula/cirugía , Prótesis e ImplantesRESUMEN
INTRODUCTION: Plasma cell leukaemia (PCL) is a rare variant of multiple myeloma. We report a case of PCL to demonstrate the clonal evolution, resulting in disease relapse after achieving complete remission, and its aggressive nature of the disease, leading to poor clinical outcome. CASE REPORT: A 69-year-old man presented with a three-day-history of worsening generalized body weakness, poor oral intake, nausea, significant loss of weight and lower back pain. He was diagnosed as primary PCL, based on hypercalcaemia, renal insufficiency, anaemia, thrombocytopenia, lytic bone lesions, 24% abnormal plasma cells in peripheral blood, immunophenotype of clonal plasma cells which were positive for CD38, CD138 and CD56 markers with kappa light chain restriction, 49% abnormal plasma cells in bone marrow, monoclonal paraprotein (IgG kappa) in serum and urine, and positive IGH rearrangement (Fluorescence in-situ hybridisation, FISH). He achieved complete remission after four cycles of Bortezomib-based therapy. There was a plan for high-dose therapy plus autologous haematopoietic cell transplantation. A month later, the disease relapsed, as evidenced by 94% abnormal plasma cells in his bone marrow aspirate, complex karyotype and abnormal FISH results. He passed away a few days later, from severe septicaemia. Time-to-progression of disease was 1 month and overall survival was 5 months. DISCUSSION: This case report illustrates the clonal evolution and aggressive nature of primary PCL with older age at presentation, leading to a shorter duration of remission and overall survival.
Asunto(s)
Leucemia de Células Plasmáticas/patología , Recurrencia Local de Neoplasia/patología , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Bortezomib/administración & dosificación , Ciclofosfamida/administración & dosificación , Dexametasona/administración & dosificación , Progresión de la Enfermedad , Resultado Fatal , Humanos , Leucemia de Células Plasmáticas/tratamiento farmacológico , Masculino , Inducción de RemisiónRESUMEN
The aim of this study was to synthesize, characterize, and observe the catalytic activity of Pd1Au1 supported by vapor-grown carbon nanofiber (VGCNF) anode catalyst prepared via the chemical reduction method. The formation of the single-phase compounds was confirmed by X-ray diffraction (XRD) and Rietveld refinement analysis, which showed single peaks corresponding to the (111) plane of the cubic crystal structure. Further analysis was carried out by field emission scanning emission microscopy (FESEM), energy dispersive X-ray analysis (EDX), nitrogen adsorption/desorption measurements, and X-ray photoelectron spectroscopy (XPS). The electrochemical performance was examined by cyclic voltammetry tests. The presence of mesoporous VGCNF as support enables the use of a relatively small amount of metal catalyst that still produces an excellent current density (66.33 mA cm-2). Furthermore, the assessment of the kinetic activity of the nanocatalyst using the Tafel plot suggests that Pd1Au1/VGCNF exerts a strong electrocatalytic effect in glycerol oxidation reactions. The engineering challenges are apparent from the fact that the application of the homemade anode catalyst to the passive direct glycerol fuel cell shows the power density of only 3.9 mW cm-2. To understand the low performance, FESEM observation of the membrane electrode assembly (MEA) was carried out, examining several morphological defects that play a crucial role and affect the performance of the direct glycerol fuel cell.
RESUMEN
Different types of infant foods categorized as formulas, cereals, and purees imported from seven different countries and available on the Kuwaiti retail market were collected for arsenic analysis. The samples were analyzed both for total arsenic concentration using ICP-MS and for arsenic speciation using HPLC-ICP-MS. Speciation is essential for food analysis because of the toxicity and carcinogenicity of inorganic arsenic species. There was a strong positive linear correlation between the total and inorganic arsenic levels in the tested infant foods at the 95% confidence level. Arsenic concentrations detected in this study were implemented to calculate the total daily intake of arsenic, where the calculated daily intake values were utilized to assess the potential health risks to infants incurred by consuming different infant foods by calculating three different assessment indices namely, hazard quotient (HQ), cancer risk (CR), and margin of exposure (MOE). Both the total arsenic content and the safety of the investigated infant foods were compared to the ones associated with 406 different infant food types from seven different countries reported in the literature. This study confirms that infants are exposed to arsenic via diet since rice-based infant food products contained elevated levels of arsenic; consequently, warranting careful attention to diet choices both to limit this exposure and to avert potentially hazardous adverse health effects to the infants.
Asunto(s)
Arsénico/análisis , Alimentos Infantiles/análisis , Arsénico/efectos adversos , Cromatografía Líquida de Alta Presión , Intervalos de Confianza , Humanos , Espectrometría de Masas , Medio Oriente/epidemiología , Neoplasias/epidemiología , Oryza/química , Medición de RiesgoRESUMEN
BACKGROUND: "Health Care Workers in Conflict Areas" emerged as one of the priority themes for a Lancet Commission addressing health in conflict. The objective of our study was to conduct a scoping review on health workers in the setting of the Syrian conflict, addressing four topics of interest: violence against health care workers, education, practicing in conflict setting, and migration. METHODS: Considering the likelihood of scarcity of data, we broadened the scope of the scoping review to include indirect evidence on health care workers from other countries affected by the "Arab Spring". We electronically searched six electronic databases. We conducted descriptive analysis of the general characteristics of the included papers. We also used the results of this scoping review to build an evidence gap map. RESULTS: Out of the 11 165 identified citations, 136 met our eligibility criteria. The majority of the articles tackled the issue of violence against health care workers (63%) followed by practicing in conflict setting (19%), migration (17%) and education (10%). Countries in focus of most articles were: Syria (35%), Iraq (33%), and Bahrain (29%). News, editorials, commentaries and opinion pieces made up 81% of all included papers, while primary studies made up only 9%. All the primary studies identified in this review were conducted on Iraq. Most of the articles about violence against health care workers were on Bahrain, followed by Syria and Iraq. The first and corresponding authors were most frequently affiliated with institutions from non-Arab countries (79% and 79% respectively). CONCLUSIONS: Research evidence on health care workers in the setting of the "Arab Spring" is scarce. This review and the gap map can inform the research agendas of funders and researchers working in the field of health care workers in conflict setting. More well-designed primary studies are needed to inform the decisions of policymakers and other interested parties.
Asunto(s)
Personal de Salud , Guerra , Humanos , SiriaRESUMEN
Implantation of ovarian tissue allografts in outbred Wistar rats and inbred August rats against the background of induction of donor-specific tolerance was accompanied by an increase in liver content of mononuclear cells expressing LMP2 immune of proteasome subunit by day 37 after transplantation in comparison with day 0. Graft rejection, on the contrary, was associated with a decrease in the number of LMP2+ cells in the liver of rats of both lines during this period. The difference in the content of these cells and the graft take rate were higher in Wistar rats. The number of mononuclear cells expressing LMP7 immune proteasome subunit in the liver did not change in rats of both lines by day 37 in comparison with day 0. Thus, the level of immune proteasomes with LMP2 subunit in mononuclear cells of the liver is related to fine mechanisms of regulation of immune responses and their shift toward graft take or rejection.
Asunto(s)
Leucocitos Mononucleares/citología , Hígado/citología , Hígado/inmunología , Ovario/trasplante , Complejo de la Endopetidasa Proteasomal/metabolismo , Animales , Línea Celular , Cisteína Endopeptidasas/metabolismo , Femenino , Citometría de Flujo , Tolerancia Inmunológica , Leucocitos Mononucleares/metabolismo , Ratas , Ratas Endogámicas , Ratas Wistar , Especificidad de la Especie , Bazo/inmunología , Trasplante HomólogoRESUMEN
BACKGROUND: A transparent and explicit reporting on authors' contributions to the development of clinical practice guidelines and on panelists' characteristics is essential for their credibility and trustworthiness. We did not find published studies on authorship or panel involvement in clinical practice guidelines. OBJECTIVE: To describe the approach to authorship in reports of clinical practice guidelines, and the characteristics of individual authors. METHODS: We conducted a cross-sectional survey of guidelines listed in the National Guideline Clearing House (NGC) in 2016. We abstracted data on the general characteristics of the guidelines, report approach to authorship, and individual authors characteristics. Data abstraction was in duplicate and independent manner using standardised form. Data analyses were both descriptive and regression analyses. RESULTS: Overall, 139 eligible guidelines with published papers were identified. Of these, 48 (35%) included a group authorship statement in the author byline. A third of these guidelines (n = 45; 32%) reported on authors' contributions, while about half of the guidelines (n = 74; 53%) reported who of the authors served as panel members. Around one-fifth of the guidelines (n = 30; 22%) reported group membership (eg, content expert, patient representative) for at least 1 author. Less than one-seventh of the eligible guidelines indicated who selected the panel members (n = 18; 13%), reported the types of panel members (n = 18; 13%) or the selection criteria (n = 12; 9%). Higher journal impact factor was associated with both "reporting of the author contributions" (OR = 1.07) and "the inclusion of a panel membership section in the guideline report" (OR = 1.21). CONCLUSION: Low percentages of clinical practice guidelines report information on important aspects of authorship and characteristics of individual authors. Better reporting of some of these criteria was associated with journal impact factor.
Asunto(s)
Autoria/normas , Guías como Asunto/normas , Factor de Impacto de la Revista , Escritura Médica/normas , Estudios Transversales , Humanos , Edición/normas , Sociedades Científicas/normasRESUMEN
BACKGROUND: Public health journals need to have clear policies for reporting the funding of studies and authors' personal financial and non-financial conflicts of interest (COI) disclosures. This study aims to assess the policies of public health journals on reporting of study funding and the disclosure of authors' COIs. METHODS: This is a cross-sectional study of "Public, Environmental & Occupational Health" journals. Teams of two researchers abstracted data in duplicate and independently using REDCap software. RESULTS: Of 173 public health journals, 155 (90%) had a policy for reporting study funding information. Out of these, a majority did not require reporting of the phase of the study for which funding was received (88%), nor the types of funding sources (87%). Of the 173 journals, 163 (94%) had a policy requiring disclosure of authors' COI. However, the majority of these journals did not require financial conflicts of interest disclosures relating to institutions (75%) nor to the author's family members (90%) while 56% required the disclosure of at least one form of non-financial COI. CONCLUSIONS: The policies of the majority of public health journals do not require the reporting of important details such as the role of the funder, and non-financial COI. Journals and publishers should consider revising their editorial policies to ensure complete and transparent reporting of funding and COI.
Asunto(s)
Políticas Editoriales , Publicaciones Periódicas como Asunto/normas , Salud Pública , Conflicto de Intereses , Estudios Transversales , Revelación , Apoyo Financiero , HumanosRESUMEN
Induction of donor-specific tolerance in outbred Wistar rats (RT1u) and inbred August rats (RT1c) increased the expression of immune proteasome subunits in liver with a peak on day 7 after beginning of the induction. The increase in the level of immune subunits LMP2 and LMP7 was more pronounced in the liver of August rats in comparison with Wistar rats (by 2 and 6 times, respectively), which was associated with higher concentrations of monoamines in the CNS of August rats. After induction of donor-specific tolerance in August and Wistar rats, the immune subunits were in cells of sinusoidal lining and in cells located in sinusoid lumens. It can be suggested that immune proteasomes in these cells producing antigenic peptides for presentation to immunocompetent participate in the suppression of their activity and form the molecular basis for the development of donor-specific tolerance at very early stages of this process.