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3.
Transl Androl Urol ; 12(7): 1071-1078, 2023 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-37554536

RESUMO

Background: To determine effects of sexual health curriculum (SHC) in medical school and mentorship on future specialty/subspecialty selection, we sought to evaluate the experiences of urology trainees and practicing urologists. Methods: Residents, fellows, and practicing urologists completed a 15-question survey regarding their exposure to a SHC during medical school, topics covered, and the influence of mentors in their career choice. Summary statistics were used to identify trends based on survey responses. Results: Ninety-four respondents, primarily post-graduate training year 4 and 5 (46%), completed the survey. Approximately 50% recalled a dedicated SHC during medical school with 46% planning to pursue fellowship training in sexual medicine/reconstruction. Topics commonly covered included reproductive anatomy/physiology and sexual history-taking, while respondents rarely recalled topics such as sexual aids/toys and pornography. Only 25% felt their SHC provided an adequate fund of knowledge to address sexual health concerns in patients, and only 14% felt that exposure to a SHC influenced their decision to pursue urology. Individuals intending to pursue fellowship were more likely to have an attending mentor, a mentor with expertise in sexual dysfunction, and considered their mentor as important or very important in their decision to subspecialize (P<0.05). Conclusions: Most urology trainees do not have strong exposure to a SHC during medical school and cite mentorship as a more important role in the decision to pursue subspecialty training. These data support the need for a standardized formal SHC and continued exposure to sexual health experts during training to ensure continued interest in sexual medicine/reconstruction fellowship.

4.
Ecohealth ; 20(2): 178-193, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-37523018

RESUMO

This analysis investigates the relationship between drought and antiretroviral treatment (ART) adherence and retention in HIV care in the Hlabisa sub-district, KwaZulu-Natal, South Africa. Data on drought and ART adherence and retention were collated for the study period 2010-2019. Drought was quantified using the 3-month Standard Precipitation Evapotranspiration Index (SPEI) and Standard Precipitation Index (SPI) from station data. Adherence, proxied by the Medication Possession Ratio (MPR), and retention data were obtained from the public ART programme database. MPR and retention were calculated from individuals aged 15-59 years who initiated ART between January 2010 and December 2018 and visited clinic through February 2019. Between 01 January 2010 and 31 December 2018, 40,714 individuals started ART in the sub-district and made 1,022,760 ART visits. The SPI showed that 2014-2016 were dry years, with partial recovery after 2016 in the wet years. In the period from 2010 to 2012, mean 6-month MPR increased from 0.85 in July 2010 to a high of 0.92 in December 2012. MPR then decreased steadily through 2013 and 2014 to 0.78 by December 2014. The mean proportion retained in care 6 months after starting ART showed similar trends to MPR, increasing from 86.9% in July 2010 to 91.4% in December 2012. Retention then decreased through 2013, with evidence of a pronounced drop in January 2014 when the odds of retention decreased by 30% (OR = 0.70, CI = 0.53-0.92, P = 0.01) relative to the end of 2013. Adherence and retention in care decreased during the drought years.


Assuntos
Fármacos Anti-HIV , Infecções por HIV , Humanos , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Fármacos Anti-HIV/uso terapêutico , África do Sul/epidemiologia , Análise de Séries Temporais Interrompida , Secas
5.
Heliyon ; 9(5): e16096, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-37215795

RESUMO

Over the past few years, there has been growing interest in using inorganic quaternary nitrate-based molten salt mixtures as a highly effective heat transfer fluid (HTF) for concentrated power plants, primarily because they can achieve low melting temperatures. However, the high viscosity of these salt mixtures is still a significant challenge that hinders their widespread adoption. The high viscosity leads to high pumping power requirements, which increases operational costs, and reduces the efficiency of the Rankine cycle. To address this challenge, this study developed and characterized a novel quaternary molten salt, focusing on the effect of LiNO3 additions on the salt's viscosity, thermal conductivity, melting point temperature, heat capacity, and thermal stability. The quaternary mixture comprised KNO3, LiNO3, Ca(NO3)2, and NaNO2, with varying percentages of each salt. The study utilized various standard techniques to examine the characteristics of the developed mixture. Results showed that increasing LiNO3 content led to a decrease in melting temperature, higher heat capacity, improved thermal stability, conductivity, and reduced viscosity at solidification temperature. The lowest endothermic peak for the new mixture emerged at 73.5 °C, which is significantly lower than that of commercial Hitec and Hitec XL, indicating better potential for use as a heat transfer fluid for concentrated solar thermal power plant applications. Furthermore, the thermal stability results showed high stability up to 590 °C for all the samples examined. Overall, the new quaternary molten salt shows promise as a potential replacement for current organic synthetic oil, offering a more efficient solution.

6.
Urology ; 174: 18-22, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36773956

RESUMO

OBJECTIVE: To review historical and examination findings in patients presenting to a tertiary care center for evaluation of Chronic Scrotal Content Pain (CSCP) defined by persistent/bothersome pain present for > 3-months. METHODS: We performed a retrospective chart review of all patients presenting to our medical center for evaluation of CSCP. Pertinent information collected included historical data, physical examination findings, laboratory and imaging results, and treatments recommended by the assessing physician. The data was summarized to present a cross-sectional representation of patients presenting for CSCP. RESULTS: 110 patients were identified. 80 patients (73%) had seen at least one prior urologist. 26 patients (24%) had undergone a prior unsuccessful surgical intervention for CSCP. Reproducible tenderness was present in 67% of patients including testicular tenderness in 50 (45%), epididymal tenderness in 60 (55%), and spermatic cord tenderness in 31 patients (28%). 33% of patients did not have any reproductible scrotal content tenderness on physical examination. Surgery was recommended in 57/110 patients (52%), including microdenervation in 22%. Musculoskeletal etiologies were suspected based on specific aspects of the history and physical examination in 43 patients (39%), prompting additional evaluation and/or referrals. CONCLUSION: CSCP presents with a wide array of symptoms and many patients do not have reproducible findings on examination, suggesting alternative sources of pain such as referred pain from musculoskeletal causes. The history and physical examination should include assessments for concurrent abdominal, back, hip, and other genital/pelvic pain that may suggest alternative diagnoses and referrals for appropriate treatment.


Assuntos
Dor Crônica , Doenças dos Genitais Masculinos , Dermatopatias , Doenças Testiculares , Masculino , Humanos , Centros de Atenção Terciária , Estudos Retrospectivos , Estudos Transversais , Doenças dos Genitais Masculinos/cirurgia , Doenças Testiculares/complicações , Doenças Testiculares/diagnóstico , Doenças Testiculares/cirurgia , Dor Crônica/diagnóstico , Dor Crônica/etiologia , Dor Crônica/cirurgia , Escroto , Dor Pélvica/diagnóstico , Dor Pélvica/etiologia , Dor Pélvica/terapia
8.
Rev Sci Tech ; 41(1): 219-227, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35925619

RESUMO

A network of scientists involved in shipment of live insects has met and generated a series of articles on issues related to live insect transport. The network is diverse, covering large-scale commercial interests, government operated areawide control programmes, biomedical research and many smaller applications, in research, education and private uses. Many insect species have a record of safe transport, pose minimal risks and are shipped frequently between countries. The routine shipments of the most frequently used insect model organism for biomedical research, Drosophila melanogaster, is an example. Successful large scale shipments from commercial biocontrol and pollinator suppliers also demonstrate precedents for low-risk shipment categories, delivered in large volumes to high quality standards. Decision makers need access to more information (publications or official papers) that details actual risks from the insects themselves or their possible contaminants, and should propose proportionate levels of management. There may be harm to source environments when insects are collected directly from the wild, and there may be harm to receiving environments. Several risk frameworks include insects and various international coordinating bodies, with experience of guidance on relevant risks, exist. All stakeholders would benefit from an integrated overview of guidance for insect shipping, with reference to types of risk and categories of magnitude, without trying for a single approach requiring universal agreement. Proposals for managing uncertainty and lack of data for smaller or infrequent shipments, for example, must not disrupt trade in large volumes of live insects, which are already supporting strategic objectives in several sectors.


À l'occasion d'une réunion d'experts, un réseau de chercheurs travaillant sur l'expédition d'insectes vivants a produit un ensemble d'articles traitant des questions liées au transport des insectes vivants. Ce réseau est diversifié et représente un large éventail d'intérêts privés et de programmes de lutte biologique à grande échelle menés par les pouvoirs publics, en plus du secteur de la recherche biomédicale et de nombreux acteurs intervenant dans des applications de plus petite envergure relevant de la recherche, de l'enseignement ou du secteur privé. Un grand nombre d'espèces d'insectes sont transportées en toute sécurité avec un niveau de risque minimal, y compris lors des fréquentes expéditions internationales. Un exemple de ces expéditions régulières concerne l'espèce la plus utilisée par la recherche biomédicale en tant qu'organisme modèle, à savoir Drosophila melanogaster. Les exemples réussis d'expéditions à grande échelle provenant de fournisseurs d'agents de lutte biologique et de pollinisateurs produits par le secteur privé offrent également un relevé documenté des diverses catégories d'expéditions à faible risque pour des livraisons d'insectes vivants en grandes quantités et répondant à des normes de qualité élevées. Les décideurs politiques devraient pouvoir accéder à plus d'informations (à travers des publications ou des articles officiels) décrivant en détail les risques réels associés aux insectes eux-mêmes ou à leurs contaminants éventuels, et proposer en connaissance de cause des niveaux de gestion proportionnels à ces risques. La récolte d'insectes prélevés directement de la nature peut être dommageable aussi bien pour les environnements source que pour ceux de destination. Plusieurs cadres fondés sur le risque intègrent désormais les insectes dans leurs directives. Par ailleurs, nombre d'organismes internationaux de coordination ont acquis une expérience dans l'élaboration de lignes directrices face à ces risques. Il serait bénéfique pour toutes les parties prenantes de disposer d'une vue d'ensemble intégrée des directives applicables aux expéditions d'insectes, qui recense les différents types de risque et leurs ordres de grandeur sans se prononcer sur une approche unique qui nécessiterait une adhésion universelle. Ni les propositions visant à gérer l'incertitude ni l'insuffisance des données disponibles sur les expéditions d'insectes en petits nombres ou occasionnelles ne doivent perturber les échanges commerciaux d'insectes vivants en grandes quantités, échanges qui participent aujourd'hui aux objectifs stratégiques de nombreux secteurs.


Una red de científicos relacionados de un modo u otro con el transporte de insectos vivos mantuvo un encuentro y generó una serie de artículos en torno a la cuestión. En la red, muy heterogénea, convergen desde intereses comerciales de gran calado hasta programas públicos de lucha biológica en grandes territorios, pasando por la investigación biomédica y por numerosas aplicaciones de menor dimensión en ámbitos como la investigación, la enseñanza u otros usos privados. Muchas especies de insectos cuentan con un buen historial de seguridad en el transporte, presentan un riesgo mínimo y son expedidas a menudo de un país a otro. Buen ejemplo de ello son los envíos sistemáticos de ejemplares de Drosophila melanogaster, que es el insecto utilizado con más frecuencia como organismo modelo en la investigación biomédica. Otro precedente de envíos voluminosos cuyo transporte y entrega se ajusta a los más exigentes criterios de calidad lo sientan las remesas de grandes cantidades de polinizadores y agentes de control biológico remitidos por proveedores comerciales. Los responsables de adoptar decisiones deben disponer de más y más detallada información (publicaciones o documentos oficiales) sobre los riesgos reales derivados de los propios insectos o sus posibles contaminantes para proponer a partir de ahí medidas de gestión proporcionadas. Los perjuicios ambientales pueden darse tanto en origen (cuando hay captura salvaje de insectos, o sea recolección directa en el medio) como en destino. Hay varios sistemas de determinación del riesgo que incluyen a los insectos y también existen diversos organismos de coordinación internacional que ya tienen experiencia en sentar pautas sobre los riesgos en la materia. Todos los interlocutores del sector se beneficiarían de una visión global e integrada del transporte de insectos, que remita a diferentes tipos de riesgo y categorías de magnitud, sin necesidad de buscar un sistema único que exija consenso universal. Las propuestas para gestionar la incertidumbre y la falta de información en el caso de envíos infrecuentes o de pequeñas dimensiones, por ejemplo, no deben interferir en el transporte de grandes cantidades de insectos vivos, que ya está sirviendo a objetivos estratégicos en varios sectores.


Assuntos
Pesquisa Biomédica , Drosophila melanogaster , Animais , Comércio , Insetos
9.
Rev Sci Tech ; 41(1): 191-197, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35925622

RESUMO

A commitment to reducing pesticide use and the development of novel technologies are driving a renewed interest in insect-mediated pest and vector control programmes. Such programmes, along with conservation and pollination applications, lead to an increased transport volume of live insect stock. At release sites, concerns surrounding imported insects can be reduced by using local genotypes that have been mass-produced elsewhere. Remaining plausible concerns are likely to be centred on human factors (vector behaviour or capacity) and ecological factors (interacting species) and should be anticipated in the design of communication materials. Well-designed, locally relevant communication and engagement material is an important part of programme success. Stakeholder engagement is thus critical to reducing risks of perceived and plausible concerns affecting programme outcomes in an increasingly electronically connected world. Experience at release sites can help inform the design of accessible information useful at all stages of the transportation pathway. For transnationally transported insects, providing such information to specific stakeholders (e.g. courier companies and border authorities) will reduce the likelihood of delays, which can, in turn, affect the quality and mortality of the transported insects.


Les engagements pris en matière de réduction de l'utilisation de pesticides et les nouvelles technologies disponibles ont donné un nouvel essor aux programmes de contrôle des parasites et des vecteurs axés sur les insectes. Ces programmes, auxquels s'ajoutent d'autres applications destinées à favoriser la conservation et la pollinisation, se traduisent par un accroissement du volume de stocks d'insectes vivants transportés dans le monde. Dans les sites de destination des insectes transportés, les inquiétudes que peuvent susciter ces importations peuvent être tempérées en faisant appel à des génotypes locaux, produits en masse ailleurs puis réintroduits. D'autres préoccupations peuvent subsister, portant sur des facteurs humains (liées aux effets du comportement des vecteurs ou à leur capacité vectorielle) et écologiques (liées aux espèces en interaction) ; il convient d'anticiper ces inquiétudes lors de la conception des supports de communication. Des matériels de communication et de mobilisation bien conçus et prenant en compte le contexte local sont une composante importante de la réussite d'un programme. La participation des parties prenantes se révèle donc cruciale pour réduire le risque que des inquiétudes perçues et plausibles viennent affecter les résultats d'un programme dans un monde de plus en plus interconnecté par voie électronique. L'expérience acquise dans les sites de lâchers d'insectes peut contribuer à documenter la conception d'une information accessible, qui sera utile à chaque étape de la procédure de transport. Lorsqu'il s'agit d'insectes transportés au-delà des frontières nationales, la diffusion de ce type d'information à des intervenants spécifiques (par exemple, les sociétés de transport express et les autorités frontalières) permettra de limiter les circonstances entraînant des retards d'acheminement, car ceux-ci peuvent à leur tour affecter la qualité et la viabilité des insectes transportés.


El empeño de reducir el uso de plaguicidas y la aparición de tecnologías novedosas están alimentando un renovado interés por los programas de control de plagas y vectores mediante insectos. Este tipo de programas, junto con las aplicaciones de los insectos con fines de polinización o de protección ambiental, se traducen en el transporte de volúmenes crecientes de poblaciones de insectos vivos. Para apaciguar los recelos que despiertan los insectos importados en los sitios de suelta cabe recurrir al empleo de genotipos locales criados a gran escala en otro lugar. A la hora de concebir el material de comunicación es conveniente prever de antemano y tener en cuenta las suspicacias plausibles que aún puedan subsistir, que seguramente tendrán que ver con factores humanos (por ejemplo, preocupación por los posibles efectos del comportamiento o la capacidad vectorial del insecto introducido) o ecológicos (interacción con otras especies). El uso de material de comunicación y participación bien concebido y adaptado al contexto local es un ingrediente importante para el éxito de todo programa. La participación de las partes interesadas es pues fundamental para reducir los riesgos (ya sean imaginados o plausibles) que puedan afectar los resultados del programa, en un mundo que está cada vez más interconectado electrónicamente. La experiencia adquirida en los sitios de suelta puede ayudar a concebir material informativo accesible que sea de utilidad en todas las etapas del proceso de transporte. En el caso de los insectos transportados de un país a otro, el hecho de facilitar esta información a determinadas partes (como las empresas de transporte o las autoridades aduaneras) reducirá la probabilidad de demoras, cosa que a su vez incidirá en la calidad y la viabilidad de los insectos transportados.


Assuntos
Controle de Insetos , Insetos , Animais , Humanos
10.
Environ Sci Pollut Res Int ; 29(30): 45070-45088, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35461423

RESUMO

A number of parasiticides are commercially available as companion animal treatments to protect against parasite infestation and are sold in large volumes. These treatments are not intended to enter the wider environment but may be washed off or excreted by treated animals and have ecotoxic impacts. A systematic literature review was conducted to identify the existing evidence for the toxicity of the six most used parasiticides in the UK: imidacloprid, fipronil, fluralaner, afoxolaner, selamectin, and flumethrin. A total of 17,207 published articles were screened, with 690 included in the final evidence synthesis. All parasiticides displayed higher toxicity towards invertebrates than vertebrates, enabling their use as companion animal treatments. Extensive evidence exists of ecotoxicity for imidacloprid and fipronil, but this focuses on exposure via agricultural use and is not representative of environmental exposure that results from use in companion animal treatments, especially in urban greenspace. Little to no evidence exists for the ecotoxicity of the remaining parasiticides. Despite heavy usage, there is currently insufficient evidence to understand the environmental risk posed by these veterinary treatments and further studies are urgently needed to quantify the levels and characterise the routes of environmental exposure, as well as identifying any resulting environmental harm.


Assuntos
Antiparasitários , Inseticidas , Animais , Inseticidas/toxicidade , Neonicotinoides , Nitrocompostos/toxicidade , Animais de Estimação , Reino Unido
11.
Lancet Planet Health ; 6(4): e359-e370, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35397224

RESUMO

Climate change is directly and indirectly linked to human health, including through access to treatment and care. Our systematic review presents a systems understanding of the nexus between drought and antiretroviral therapy (ART) adherence in HIV-positive individuals in the African setting. Narrative synthesis of 111 studies retrieved from Web of Science, PubMed/MEDLINE, and PsycINFO suggests that livelihoods and economic conditions, comorbidities and ART regimens, human mobility, and psychobehavioural dispositions and support systems interact in complex ways in the drought-ART adherence nexus in Africa. Economic and livelihood-related challenges appear to impose the strongest impact on human interactions, actions, and systems that culminate in non-adherence. Indeed, the complex pathways identified by our systems approach emphasise the need for more integrated research approaches to understanding this phenomenon and developing interventions.


Assuntos
Secas , Infecções por HIV , África , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Humanos , Adesão à Medicação , Cooperação e Adesão ao Tratamento
12.
Pest Manag Sci ; 78(7): 2729-2745, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35294802

RESUMO

The risks of Aedes aegypti and Aedes albopictus nuisance and vector-borne diseases are rising and the adverse effects of broad-spectrum insecticide application have promoted species-specific techniques, such as sterile insect technique (SIT) and other genetic strategies, as contenders in their control operations. When specific vector suppression is proposed, potential effects on predators and wider ecosystem are some of the first stakeholder questions. These are not the only Aedes vectors of human diseases, but are those for which SIT and genetic strategies are of most interest. They vary ecologically and in habitat origin, but both have behaviorally human-adapted forms with expanding ranges. The aquatic life stages are where predation is strongest due to greater resource predictability and limited escape opportunity. These vectors' anthropic forms usually use ephemeral water bodies and man-made containers as larval habitats; predators that occur in these are mobile, opportunistic and generalist. No literature indicates that any predator depends on larvae of either species. As adults, foraging theory predicts these mosquitoes are of low profitability to predators. Energy expended hunting and consuming will mostly outweigh their energetic benefit. Moreover, as adult biomass is mobile and largely disaggregated, any predator is likely to be a generalist and opportunist. This work, which summarizes much of the literature currently available on the predators of Ae. aegypti and Ae. albopictus, indicates it is highly unlikely that any predator species depends on them. Species-specific vector control to reduce nuisance and disease is thus likely to be of negligible or limited impact on nontarget predators. © 2022 The Authors. Pest Management Science published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.


Assuntos
Aedes , Dengue , Febre Amarela , Animais , Ecossistema , Humanos , Larva , Mosquitos Vetores
13.
J Med Case Rep ; 16(1): 99, 2022 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-35232468

RESUMO

INTRODUCTION: Hereditary hemorrhagic telangiectasia is an autosomal dominant condition with an estimated prevalence of 1 in 5000. It is characterized by the presence of abnormalities of vascular structures, and may affect many organ systems, including the lungs, brain, spinal cord, gastrointestinal tract, and liver. A causative mutation is identified in approximately 97% of patients with definite hereditary hemorrhagic telangiectasia in one of three genes including a mutation in endoglin, a mutation in a locus mapped to chromosome 5, and an activin receptor-like kinase-1 (ACVRL1) mutation that is associated with an increased incidence of primary pulmonary hypertension. Pulmonary arterial hypertension is a rare (15-25 cases per million people) but severe vascular disorder. Heritable pulmonary arterial hypertension is associated with several gene mutations, with 75% having a mutation in the bone morphogenetic protein receptor 2 (BMPR2). However, the remaining 25% of patients have other associated genetic mutations including ACVLR1, which is also associated with hereditary hemorrhagic telangiectasia. Pulmonary arterial hypertension is a rare complication in patients with hereditary hemorrhagic telangiectasia (< 1% of the hereditary hemorrhagic telangiectasia population). We describe a case report with this rare occurrence. CASE PRESENTATION: A 70-year-old white/caucasian Irish male presented for screening for hereditary hemorrhagic telangiectasia due to a history of recurrent epistaxis (once/week) and a family history suggestive of pulmonary hypertension. Genetic testing confirmed an ACVRL1 mutation, while an echocardiogram and right heart catheterization confirmed pulmonary arterial hypertension. On examination, he had several mucocutaneous telangiectasia across his face. He was commenced on tadalafil and macitentan. However, this led to increased iron deficiency anemia and pedal edema. Selexipag was also added to his drug regime. He continues to require intermittent admissions for diuresis and blood transfusions. CONCLUSION: The association of hereditary hemorrhagic telangiectasia and pulmonary arterial hypertension is rare (< 1%). Here we describe a case of hereditary hemorrhagic telangiectasia complicated with pulmonary arterial hypertension as a result of an ACVRL1 mutation. We also describe the clinical challenges of treating these two conditions together, as treatment options for pulmonary arterial hypertension tend to worsen hereditary hemorrhagic telangiectasia symptoms.


Assuntos
Hipertensão Pulmonar , Hipertensão Arterial Pulmonar , Telangiectasia Hemorrágica Hereditária , Receptores de Activinas Tipo II/genética , Idoso , Endoglina/genética , Humanos , Hipertensão Pulmonar/etiologia , Hipertensão Pulmonar/genética , Masculino , Mutação , Hipertensão Arterial Pulmonar/etiologia , Hipertensão Arterial Pulmonar/genética , Telangiectasia Hemorrágica Hereditária/complicações , Telangiectasia Hemorrágica Hereditária/diagnóstico , Telangiectasia Hemorrágica Hereditária/genética
14.
Int J Immunogenet ; 49(1): 22-29, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34555264

RESUMO

All UK H&I laboratories and transplant units operate under a single national kidney offering policy, but there have been variations in approach regarding when to undertake the pre-transplant crossmatch test. In order to minimize cold ischaemia times for deceased donor kidney transplantation we sought to find ways to be able to report a crossmatch result as early as possible in the donation process. A panel of experts in transplant surgery, nephrology, specialist nursing in organ donation and H&I (all relevant UK laboratories represented) assessed evidence and opinion concerning five factors that relate to the effectiveness of the crossmatch process, as follows: when the result should be ready for reporting; what level of donor HLA typing is needed; crossmatch sample type and availability; fairness and equity; risks and patient safety. Guidelines aimed at improving practice based on these issues are presented, and we expect that following these will allow H&I laboratories to contribute to reducing CIT in deceased donor kidney transplantation.


Assuntos
Transplante de Rim , Tipagem e Reações Cruzadas Sanguíneas , Isquemia Fria , Antígenos HLA , Teste de Histocompatibilidade , Humanos , Rim
15.
Sex Med Rev ; 10(1): 53-70, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34362711

RESUMO

INTRODUCTION: Persistent genital arousal disorder (PGAD) is an uncommon condition resulting in intrusive, unwanted and distressing symptoms of genital arousal. Presentation can vary and most cases do not have an immediately identifiable etiology. OBJECTIVES: To present evaluation and treatment recommendations for PGAD from a multidisciplinary perspective and provide case examples. METHODS: A focused review of the literature on diagnosis, workup, and treatment of PGAD was completed. A case series of 3 varying presentations of PGAD is offered. RESULTS: PGAD results in high levels of patient distress and is best managed with a multidisciplinary treatment approach. Identification and management of co-occurring symptoms or disease states is imperative, particularly psychologic and psychiatric comorbidities. With appropriate intervention, patients may achieve improvement of their physical symptoms and a decrease in associated psychological distress. CONCLUSION: PGAD is an uncommon and highly distressing condition that requires thoughtful evaluation for appropriate diagnosis and treatment. Multidisciplinary treatment approaches provide the best opportunity to address the needs of patients and optimizing treatment response. Pease ER, Ziegelmann M, Vencill JA, et al. Persistent Genital Arousal Disorder (PGAD): A Clinical Review and Case Series in Support of Multidisciplinary Management. Sex Med Rev 2022;10:53-70.


Assuntos
Disfunções Sexuais Psicogênicas , Nível de Alerta/fisiologia , Genitália , Humanos , Disfunções Sexuais Psicogênicas/diagnóstico , Disfunções Sexuais Psicogênicas/etiologia , Disfunções Sexuais Psicogênicas/terapia
16.
Front Nutr ; 8: 792941, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34926558

RESUMO

Background: Undernutrition is a prevalent, serious, and growing concern, particularly in developing countries. Entomophagy-the human consumption of edible insects, is a historical and culturally established practice in many regions. Increasing consumption of nutritious insect meal is a possible combative strategy and can promote sustainable food security. However, the nutritional literature frequently lacks consensus, with interspecific differences in the nutrient content of edible insects generally being poorly resolved. Aims and methods: Here we present full proximate and fatty acid profiles for five edible insect species of socio-economic importance in West Africa: Hermetia illucens (black soldier fly), Musca domestica (house fly), Rhynchophorus phoenicis (African palm weevil), Cirina butyrospermi (shea tree caterpillar), and Macrotermes bellicosus (African termite). These original profiles, which can be used in future research, are combined with literature-derived proximate, fatty acid, and amino acid profiles to analyse interspecific differences in nutrient content. Results: Interspecific differences in ash (minerals), crude protein, and crude fat contents were substantial. Highest ash content was found in H. illucens and M. domestica (~10 and 7.5% of dry matter, respectively), highest crude protein was found in C. butyrospermi and M. domestica (~60% of dry matter), whilst highest crude fat was found in R. phoenicis (~55% of dry matter). The fatty acid profile of H. illucens was differentiated from the other four species, forming its own cluster in a principal component analysis characterized by high saturated fatty acid content. Cirina butyrospermi had by far the highest poly-unsaturated fatty acid content at around 35% of its total fatty acids, with α-linolenic acid particularly represented. Amino acid analyses revealed that all five species sufficiently met human essential amino acid requirements, although C. butyrospermi was slightly limited in leucine and methionine content. Discussion: The nutritional profiles of these five edible insect species compare favorably to beef and can meet human requirements, promoting entomophagy's utility in combatting undernutrition. In particular, C. butyrospermi may provide a source of essential poly-unsaturated fatty acids, bringing many health benefits. This, along with its high protein content, indicates that this species is worthy of more attention in the nutritional literature, which has thus-far been lacking.

17.
Phys Rev Lett ; 127(23): 235002, 2021 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-34936805

RESUMO

Fast ion phase-space flow, driven by Alfvén eigenmodes (AEs), is measured by an imaging neutral particle analyzer in the DIII-D tokamak. The flow firstly appears near the minimum safety factor at the injection energy of neutral beams, and then moves radially inward and outward by gaining and losing energy, respectively. The flow trajectories in phase space align well with the intersection lines of the constant magnetic moment surfaces and constant E-(ω/n)P_{ζ} surfaces, where E, P_{ζ} are the energy and canonical toroidal momentum of ions; ω and n are angular frequencies and toroidal mode numbers of AEs. It is found that the flow is so destructive that the thermalization of fast ions is no longer observed in regions of strong interaction. The measured phase-space flow is consistent with nonlinear hybrid kinetic-magnetohydrodynamics simulation. Calculations of the relatively narrow phase-space islands reveal that fast ions must transition between different flow trajectories to experience large-scale phase-space transport.

18.
Rev Sci Instrum ; 92(4): 043518, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-34243419

RESUMO

Sixteen new tangential views for the charge exchange recombination (CER) spectroscopy diagnostic at DIII-D were installed in 2019 on the high-field side (HFS) of the tokamak with the main goal being the measurement of main-ion (deuterium) poloidal rotation. Eight of the new views are connected to spectrometers, which view the main-ion spectrum, adding main-ion measurements where there were previously none, and another eight new views increased the spatial resolution of existing impurity (carbon) measurements on the HFS. When combined with the existing low-field side measurements, measurements at two locations on flux surfaces out to a normalized minor radius of ≈0.6 are possible. The new tangential views have been used to measure the deuterium poloidal rotation directly for the first time using the Poloidal Asymmetry in Angular Rotation (PAAR) method. These new measurements enable further testing of the validity of neoclassical poloidal rotation predictions. Separate measurements of the radial electric field can be made for an impurity ion and the main-ion by combining the PAAR measurements with additional CER measurements of toroidal rotation, temperature, and density. These independent measurements of the radial electric field agree reasonably well.

19.
Parkinsonism Relat Disord ; 87: 166-167, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34090789

RESUMO

In response to Ferrazano and colleagues' observation of normal DAT binding in patients with isolated head tremor but with abnormal STDT, we report normal 123-IBZM SPECT in a cohort of patients with adult-onset idiopathic focal dystonia with cervical dystonia and their unaffected first-degree relatives both with normal and abnormal TDTs. We discuss molecular imaging findings in dystonia.


Assuntos
Distúrbios Distônicos , Torcicolo , Adulto , Humanos , Tomografia Computadorizada de Emissão de Fóton Único , Tremor/diagnóstico por imagem
20.
Integr Comp Biol ; 61(2): 521-537, 2021 09 08.
Artigo em Inglês | MEDLINE | ID: mdl-33999184

RESUMO

Synopsis Tails are a defining characteristic of chordates and show enormous diversity in function and shape. Although chordate tails share a common evolutionary and genetic-developmental origin, tails are extremely versatile in morphology and function. For example, tails can be short or long, thin or thick, and feathered or spiked, and they can be used for propulsion, communication, or balancing, and they mediate in predator-prey outcomes. Depending on the species of animal the tail is attached to, it can have extraordinarily multi-functional purposes. Despite its morphological diversity and broad functional roles, tails have not received similar scientific attention as, for example, the paired appendages such as legs or fins. This forward-looking review article is a first step toward interdisciplinary scientific synthesis in tail research. We discuss the importance of tail research in relation to five topics: (1) evolution and development, (2) regeneration, (3) functional morphology, (4) sensorimotor control, and (5) computational and physical models. Within each of these areas, we highlight areas of research and combinations of long-standing and new experimental approaches to move the field of tail research forward. To best advance a holistic understanding of tail evolution and function, it is imperative to embrace an interdisciplinary approach, re-integrating traditionally siloed fields around discussions on tail-related research.


Assuntos
Cauda , Animais
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