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2.
J Interprof Care ; 37(1): 118-130, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-35341438

RESUMO

Improving the productivity of the allied health workforce is a global priority in response to the increasing incidence of chronic disease, associated healthcare costs, and insufficient workforce volume. Team-based healthcare, specifically allied health transdisciplinary teams, might be a solution to improve the utilization of workforce while maintaining high-quality and value-based healthcare. Allied health transdisciplinary teams can be a valuable solution in settings where care is delivered by different allied health professionals. Transdisciplinary teams embrace overlapping skills and blur traditional professional boundaries, allowing one professional to deliver certain aspects of care without eroding the skills and knowledge that each profession offers. The objective of this scoping review is to systematically examine and map the characteristics, outcomes, facilitators, and barriers of contemporary allied health transdisciplinary models of care that have been implemented in hospital settings. The scoping review was guided by the Joanna Briggs Institute methodology and reported in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Three screening rounds were completed by two independent reviewers. Included sources were synthesized using descriptive and tabular analysis. Nine studies that evaluated hospital-based allied health transdisciplinary teams were included. One study was a randomized controlled trial, five were experimental quantitative studies, two utilized qualitative analyses, and one was a conference abstract. Most studies reported improvements in time-efficiency, quality of care, and positive stakeholder perceptions. One study reported labor and capital cost savings. Barriers and facilitators of transdisciplinary teams were categorized by the authors as person/interpersonal, workflow, organizational or implementation factors. This review presents some evidence that demonstrates the potential of hospital-based allied health transdisciplinary teams, however high-quality evidence is scarce. Further primary research should focus on stakeholder perceptions, and labor and capital cost outcomes.


Assuntos
Atenção à Saúde , Relações Interprofissionais , Humanos , Pessoal Técnico de Saúde , Hospitais , Ensaios Clínicos Controlados Aleatórios como Assunto
3.
Biology (Basel) ; 11(12)2022 Dec 06.
Artigo em Inglês | MEDLINE | ID: mdl-36552282

RESUMO

Climate warming in Antarctica involves major shifts in plant distribution and productivity. This study aims to unravel the plasticity and acclimation potential of Bryum argenteum var. muticum, a cosmopolitan moss species found in Antarctica. By comparing short-term, closed-top chamber warming experiments which mimic heatwaves, with in situ seasonal physiological rates from Cape Hallett, Northern Victoria Land, we provide insights into the general inherent resilience of this important Antarctic moss and into its adaptability to longer-term threats and stressors associated with climate change. Our findings show that B. argenteum can thermally acclimate to mitigate the effects of increased temperature under both seasonal changes and short-term pulse warming events. Following pulse warming, this species dramatically increased its carbon uptake, measured as net photosynthesis, while reductions in carbon losses, measured as dark respiration, were not observed. Rapid growth of new shoots may have confounded the effects on respiration. These results demonstrate the high physiological plasticity of this species, with acclimation occurring within only 7 days. We show that this Antarctic moss species appears to have a high level of resilience and that fast acclimation processes allow it to potentially benefit from both short-term and long-term climatic changes.

4.
Arthrosc Sports Med Rehabil ; 4(3): e877-e882, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35747643

RESUMO

Purpose: The purpose of this study was to determine the effects of blood flow restriction (BFR) using a pneumatic tourniquet on CD34+ cells, platelets, white blood cells, neutrophils, lymphocytes, lactate, and glucose compared with standard exercise. Methods: Fifteen healthy volunteers (8 males and 7 females, 28.6 ± 3.6 years old) who were able to perform the exercise sessions on a VersaClimber participated. Participants were randomized to undergo an experimental (EXP) occluded testing session using the pneumatic tourniquets on all 4 extremities and a control (CON) session. The exercise protocol concluded after 9 minutes or when participants reached a rating of perceived exertion of 20. Blood draws were performed before testing and immediately after the exercise session. Blood analysis consisted of complete blood counts as well as flow cytometry to measure peripheral CD34+ counts as a marker for hematopoietic progenitor cells (HPCs). Results: A significant increase from before to after exercise values was observed in both the EXP and CON groups with CD34+, WBC counts, platelets, and lymphocytes; however, no differences existed between EXP and CON groups for any variable. CD34+ increased in the EXP (3.1 ± 1.6 vs. 4.3 ± 1.8 cells · L-1; P < .001) and CON (3.3 ± 1.9 vs. 4.4 ± 1.4 cells · L-1; P < .001) sessions. White blood cells also significantly increased in both the EXP (7.8 ± 1.4 vs. 11.8 ± 2.5 K · L-1 K · L-1; P < .001) and CON (7.5 ± 1.8 vs. 11.3 ± 3.0 K · L-1; P < .001) sessions. Platelets also increased in both the EXP (258.6 ± 52.5 vs. 309.9 ± 52.7 K · L-1; P < .001) and CON (263.1 ± 44.7 vs. 316.1 ± 43.9 K · L-1; P < .001) sessions, and conversely, a significant decrease in the average neutrophil counts in the EXP (mean difference = -13.7%; P < .001) and CON (mean difference = -13.2%; P < .001) sessions was observed. Lymphocyte counts in the EXP (mean difference = 22.8%; P < .001) and CON (mean difference = 19.3%; P < .001) sessions increased significantly. Conclusions: There were no significant differences in systemic cellular responses when undergoing aerobic-based exercise with and without a pneumatic tourniquet system. Level of Evidence: 2, prospective comparative study.

5.
Rhinology ; 60(3): 207-217, 2022 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-35398877

RESUMO

BACKGROUND: Sudden smell loss is a specific early symptom of COVID-19, which, prior to the emergence of Omicron, had estimated prevalence of ~40% to 75%. Chemosensory impairments affect physical and mental health, and dietary behavior. Thus, it is critical to understand the rate and time course of smell recovery. The aim of this cohort study was to characterize smell function and recovery up to 11 months post COVID-19 infection. METHODS: This longitudinal survey of individuals suffering COVID-19-related smell loss assessed disease symptoms and gustatory and olfactory function. Participants (n=12,313) who completed an initial survey (S1) about respiratory symptoms, chemosensory function and COVID-19 diagnosis between April and September 2020, were invited to complete a follow-up survey (S2). Between September 2020 and February 2021, 27.5% participants responded (n=3,386), with 1,468 being diagnosed with COVID-19 and suffering co-occurring smell and taste loss at the beginning of their illness. RESULTS: At follow-up (median time since COVID-19 onset ~200 days), ~60% of women and ~48% of men reported less than 80% of their pre-illness smell ability. Taste typically recovered faster than smell, and taste loss rarely persisted if smell recovered. Prevalence of parosmia and phantosmia was ~10% of participants in S1 and increased substantially in S2: ~47% for parosmia and ~25% for phantosmia. Persistent smell impairment was associated with more symptoms overall, suggesting it may be a key marker of long-COVID illness. The ability to smell during COVID-19 was rated slightly lower by those who did not eventually recover their pre-illness ability to smell at S2. CONCLUSIONS: While smell ability improves for many individuals who lost it during acute COVID-19, the prevalence of parosmia and phantosmia increases substantially over time. Olfactory dysfunction is associated with broader persistent symptoms of COVID-19, and may last for many months following acute COVID-19. Taste loss in the absence of smell loss is rare. Persistent qualitative smell symptoms are emerging as common long-term sequelae; more research into treatment options is strongly warranted given that even conservative estimates suggest millions of individuals may experience parosmia following COVID-19. Healthcare providers worldwide need to be prepared to treat post COVID-19 secondary effects on physical and mental health.


Assuntos
Ageusia , COVID-19 , Transtornos do Olfato , Masculino , Humanos , Feminino , COVID-19/complicações , Olfato , Anosmia/etiologia , SARS-CoV-2 , Estudos de Coortes , Teste para COVID-19 , Seguimentos , Síndrome de COVID-19 Pós-Aguda , Transtornos do Olfato/epidemiologia , Transtornos do Olfato/etiologia , Transtornos do Olfato/diagnóstico
6.
Res Involv Engagem ; 7(1): 81, 2021 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-34789334

RESUMO

BACKGROUND: ReIMAGINE aims to improve the current prostate specific antigen (PSA)/biopsy risk stratification for prostate cancer (PCa) and develop a new image-based method (with biomarkers) for diagnosing high/low risk PCa in men. ReIMAGINE's varied patient and public involvement (PPI) and engagement (PE) strategy maximises the impact of its scientific output by informing and shaping the different stages of research. AIMS: Through including the voice of patients and the public, the ReIMAGINE Consortium aims to translate these different perspectives into the design and implementation process. This will improve the overall quality of the research by: reflecting the needs and priorities of patients and the public, ensuring methods and procedures are feasible and appropriate ensuring information is relevant and accessible to those being recruited to the study identifying dissemination channels relevant to patients/the public and developing outputs that are accessible to a lay audience With support from our patient/user groups, the ReIMAGINE Consortium aims to improve our ability to derive prognostic information and allocate men to the most appropriate and effective therapies, using a novel image-based risk stratification with investigation of non-imaging biomarkers. FINDINGS: We have been working with patients and the public from initiation of the project to ensure that the research is relevant to men and their families. Our PPI Sub-Committee, led by a PCa patient, has been involved in our dissemination strategy, outreach activities, and study design recommendations. For example, the sub-committee have developed a variety of informative videos relevant and accessible to those being recruited, and organised multiple online research engagement events that are accessible to a lay audience. As quoted by one of the study participants, "the more we present the benefits and opportunities to patients and the public, the more research commitment we obtain, and the sooner critical clinical questions such as PCa diagnostics will be addressed".


One in eight men will be diagnosed with prostate cancer (PCa). Most will not die of it, but our ability to identify those men whose cancer poses the greatest threat to life has, thus far, been poor. Some men are diagnosed with small cancers which will never cause them a problem, some will have treatment which is unnecessary, others will have their cancers missed, and others will be misclassified as either having low risk cancer and will therefore miss out on the appropriate treatment, or told their cancer is high risk and have unnecessary treatment. Nowhere else in modern medicine are these errors of over-diagnosis, over-treatment, missed-diagnoses, and poor risk-stratification more common. The ReIMAGINE Consortium has been developed to undertake discoveries that will correct these four key errors in the PCa diagnostic pathway. We will investigate how to best identify which men have, or will develop, aggressive prostate cancer using imaging combined with advanced biomarker analyses of blood and urine (i.e., OMICs technologies such as whole genome sequencing, targeted sequencing (e.g.: = , methylation). We will achieve this by building on established partnerships between patients, advocacy organisations, clinicians, imaging experts, molecular biologists, methodologists, and a broad range of industrial partners.The Patient and Public Involvement (PPI) sub-committee is an integral part of the study workflow, contributing to study design and recruitment, results analysis, and dissemination. The committee, led by a funded PPI co-ordinator and a patient chair, have given invaluable insight into the study modifications due to COVID-19 restrictions.

7.
Br J Surg ; 108(3): 315-325, 2021 04 05.
Artigo em Inglês | MEDLINE | ID: mdl-33760065

RESUMO

BACKGROUND: Primary endocrine therapy may be an alternative treatment for less fit women with oestrogen receptor (ER)-positive breast cancer. This study compared quality-of-life (QoL) outcomes in older women treated with surgery or primary endocrine therapy. METHODS: This was a multicentre, prospective, observational cohort study of surgery or primary endocrine therapy in women aged over 70 years with operable breast cancer. QoL was assessed using European Organisation for Research and Treatment of cancer QoL questionnaires QLQ-C30, -BR23, and -ELD14, and the EuroQol Five Dimensions 5L score at baseline, 6 weeks, and 6, 12, 18, and 24 months. Propensity score matching was used to adjust for baseline variation in health, fitness, and tumour stage. RESULTS: The study recruited 3416 women (median age 77 (range 69-102) years) from 56 breast units. Of these, 2979 (87.2 per cent) had ER-positive breast cancer; 2354 women had surgery and 500 received primary endocrine therapy (125 were excluded from analysis due to inadequate data or non-standard therapy). Median follow-up was 52 months. The primary endocrine therapy group was older and less fit. Baseline QoL differed between the groups; the mean(s.d.) QLQ-C30 global health status score was 66.2(21.1) in patients who received primary endocrine therapy versus 77.1(17.8) among those who had surgery plus endocrine therapy. In the unmatched analysis, changes in QoL between 6 weeks and baseline were noted in several domains, but by 24 months most scores had returned to baseline levels. In the matched analysis, major surgery (mastectomy or axillary clearance) had a more pronounced adverse impact than primary endocrine therapy in several domains. CONCLUSION: Adverse effects on QoL are seen in the first few months after surgery, but by 24 months these have largely resolved. Women considering surgery should be informed of these effects.


Assuntos
Antineoplásicos Hormonais/uso terapêutico , Neoplasias da Mama/terapia , Qualidade de Vida , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/metabolismo , Neoplasias da Mama/psicologia , Feminino , Humanos , Estudos Longitudinais , Mastectomia , Estudos Prospectivos , Receptores de Estrogênio/metabolismo
8.
Br J Surg ; 108(5): 499-510, 2021 05 27.
Artigo em Inglês | MEDLINE | ID: mdl-33760077

RESUMO

BACKGROUND: Rates of surgery and adjuvant therapy for breast cancer vary widely between breast units. This may contribute to differences in survival. This cluster RCT evaluated the impact of decision support interventions (DESIs) for older women with breast cancer, to ascertain whether DESIs influenced quality of life, survival, decision quality, and treatment choice. METHODS: A multicentre cluster RCT compared the use of two DESIs against usual care in treatment decision-making in older women (aged at least ≥70 years) with breast cancer. Each DESI comprised an online algorithm, booklet, and brief decision aid to inform choices between surgery plus adjuvant endocrine therapy versus primary endocrine therapy, and adjuvant chemotherapy versus no chemotherapy. The primary outcome was quality of life. Secondary outcomes included decision quality measures, survival, and treatment choice. RESULTS: A total of 46 breast units were randomized (21 intervention, 25 usual care), recruiting 1339 women (670 intervention, 669 usual care). There was no significant difference in global quality of life at 6 months after the baseline assessment on intention-to-treat analysis (difference -0.20, 95 per cent confidence interval (C.I.) -2.69 to 2.29; P = 0.900). In women offered a choice of primary endocrine therapy versus surgery plus endocrine therapy, knowledge about treatments was greater in the intervention arm (94 versus 74 per cent; P = 0.003). Treatment choice was altered, with a primary endocrine therapy rate among women with oestrogen receptor-positive disease of 21.0 per cent in the intervention versus 15.4 per cent in usual-care sites (difference 5.5 (95 per cent C.I. 1.1 to 10.0) per cent; P = 0.029). The chemotherapy rate was 10.3 per cent at intervention versus 14.8 per cent at usual-care sites (difference -4.5 (C.I. -8.0 to 0) per cent; P = 0.013). Survival was similar in both arms. CONCLUSION: The use of DESIs in older women increases knowledge of breast cancer treatment options, facilitates shared decision-making, and alters treatment selection. Trial registration numbers: EudraCT 2015-004220-61 (https://eudract.ema.europa.eu/), ISRCTN46099296 (http://www.controlled-trials.com).


Assuntos
Neoplasias da Mama/terapia , Tomada de Decisões , Técnicas de Apoio para a Decisão , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos Hormonais/uso terapêutico , Neoplasias da Mama/mortalidade , Quimioterapia Adjuvante , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Qualidade de Vida
9.
Proc Natl Acad Sci U S A ; 117(36): 22293-22302, 2020 09 08.
Artigo em Inglês | MEDLINE | ID: mdl-32839321

RESUMO

During austral summer field seasons between 1999 and 2018, we sampled at 91 locations throughout southern Victoria Land and along the Transantarctic Mountains for six species of endemic microarthropods (Collembola), covering a latitudinal range from 76.0°S to 87.3°S. We assembled individual mitochondrial cytochrome c oxidase subunit 1 (COI) sequences (n = 866) and found high levels of sequence divergence at both small (<10 km) and large (>600 km) spatial scales for four of the six Collembola species. We applied molecular clock estimates and assessed genetic divergences relative to the timing of past glacial cycles, including collapses of the West Antarctic Ice Sheet (WAIS). We found that genetically distinct lineages within three species have likely been isolated for at least 5.54 My to 3.52 My, while the other three species diverged more recently (<2 My). We suggest that Collembola had greater dispersal opportunities under past warmer climates, via flotation along coastal margins. Similarly increased opportunities for dispersal may occur under contemporary climate warming scenarios, which could influence the genetic structure of extant populations. As Collembola are a living record of past landscape evolution within Antarctica, these findings provide biological evidence to support geological and glaciological estimates of historical WAIS dynamics over the last ca 5 My.


Assuntos
Variação Genética , Invertebrados/genética , Solo , Animais , Regiões Antárticas , Mudança Climática , Camada de Gelo , Estações do Ano
10.
Water Resour Res ; 56(11)2020 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-33627891

RESUMO

In this synthesis, we assess present research and anticipate future development needs in modeling water quality in watersheds. We first discuss areas of potential improvement in the representation of freshwater systems pertaining to water quality, including representation of environmental interfaces, in-stream water quality and process interactions, soil health and land management, and (peri-)urban areas. In addition, we provide insights into the contemporary challenges in the practices of watershed water quality modeling, including quality control of monitoring data, model parameterization and calibration, uncertainty management, scale mismatches, and provisioning of modeling tools. Finally, we make three recommendations to provide a path forward for improving watershed water quality modeling science, infrastructure, and practices. These include building stronger collaborations between experimentalists and modelers, bridging gaps between modelers and stakeholders, and cultivating and applying procedural knowledge to better govern and support water quality modeling processes within organizations.

11.
Front Physiol ; 10: 804, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31316393

RESUMO

During incomplete skeletal muscle recovery from ischemia, such as that occurs with critical limb ischemia, the temporal relationship between recovery of muscle capillary perfusion and contractile function is poorly defined. We examined this relationship in BALB/cJ mice (N = 24) following unilateral hindlimb ischemia (HLI), which pre-clinically mimics the myopathy observed in critical limb ischemia patients. Specifically, we examined this relationship in two phenotypically distinct muscles (i.e., "oxidative" soleus - Sol and "glycolytic" extensor digitorum longus - EDL) 14- or 56-days after HLI. Although overall limb blood flow (LDPI) reached its' recovery peak (48% of control) by HLI d14, the capillary networks in both the Sol and EDL (whole mount confocal imaging) were disrupted and competent muscle capillary perfusion (perfused lectin+µm2/muscle µm2) remained reduced. Interestingly, both Sol and EDL muscles recovered their distinct capillary structures and perfusion (Con Sol; 0.056 ± 0.02 lectin+µm2/muscle µm2, and Con EDL; 0.039 ± 0.005 lectin+µm2/muscle µm2) by HLI d56 (Sol; 0.062 ± 0.011 lectin+µm2/muscle µm2 and EDL; 0.0035 ± 0.005 lectin+µm2/muscle µm2), despite no further improvement in limb blood flow (LDPI). Both muscles suffered severe myopathy, indicated by loss of dystrophin positive immunostaining and the absence of stimulation induced isometric force production at HLI d14. Dystrophin immunofluorescence returned at HLI d56, although neither myofiber CSA (µm2) nor isometric force production (58 and 28% sustained deficits, Sol and EDL, respectively) recovered completely in either muscle. In summary, we reveal that the temporal relationship between the restoration of muscle capillary perfusion and functional ischemic skeletal muscle regeneration favors competent muscle capillary perfusion recovery in BALB/c mice in a phenotypically non-distinct manner.

12.
New Phytol ; 223(2): 661-674, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30951191

RESUMO

Chronosequences at the forefront of retreating glaciers provide information about colonization rates of bare surfaces. In the northern hemisphere, forest development can take centuries, with rates often limited by low nutrient availability. By contrast, in front of the retreating Pia Glacier (Tierra del Fuego, Chile), a Nothofagus forest is in place after only 34 yr of development, while total soil nitrogen (N) increased from near zero to 1.5%, suggesting a strong input of this nutrient. We measured N-fixation rates, carbon fluxes, leaf N and phosphorus contents and leaf δ15 N in the dominant plants, including the herb Gunnera magellanica, which is endosymbiotically associated with a cyanobacterium, in order to investigate the role of N-fixing and mycorrhizal symbionts in N-budgets during successional transition. G. magellanica presented some of the highest nitrogenase activities yet reported (potential maximal contribution of 300 kg N ha-1  yr-1 ). Foliar δ15 N results support the framework of a highly efficient N-uptake and transfer system based on mycorrhizas, with c. 80% of N taken up by the mycorrhizas potentially transferred to the host plant. Our results suggest the symbiosis of G. magellanica with cyanobacteria, and trees and shrubs with mycorrhizas, to be the key processes driving this rapid succession.


Assuntos
Micorrizas/metabolismo , Nitrogênio/metabolismo , Traqueófitas/metabolismo , Traqueófitas/microbiologia , Regiões Antárticas , Ciclo do Carbono , Chile , Marcação por Isótopo , Fixação de Nitrogênio , Fósforo/metabolismo , Fotossíntese , Folhas de Planta/metabolismo , Solo
13.
Commun Biol ; 2: 62, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30793041

RESUMO

Abiotic and biotic factors control ecosystem biodiversity, but their relative contributions remain unclear. The ultraoligotrophic ecosystem of the Antarctic Dry Valleys, a simple yet highly heterogeneous ecosystem, is a natural laboratory well-suited for resolving the abiotic and biotic controls of community structure. We undertook a multidisciplinary investigation to capture ecologically relevant biotic and abiotic attributes of more than 500 sites in the Dry Valleys, encompassing observed landscape heterogeneities across more than 200 km2. Using richness of autotrophic and heterotrophic taxa as a proxy for functional complexity, we linked measured variables in a parsimonious yet comprehensive structural equation model that explained significant variations in biological complexity and identified landscape-scale and fine-scale abiotic factors as the primary drivers of diversity. However, the inclusion of linkages among functional groups was essential for constructing the best-fitting model. Our findings support the notion that biotic interactions make crucial contributions even in an extremely simple ecosystem.


Assuntos
Artrópodes/fisiologia , Cianobactérias/fisiologia , Fungos/fisiologia , Nematoides/fisiologia , Rotíferos/fisiologia , Tardígrados/fisiologia , Animais , Regiões Antárticas , Artrópodes/classificação , Biodiversidade , Cianobactérias/classificação , Ecossistema , Fungos/classificação , Modelos Estatísticos , Nematoides/classificação , Rotíferos/classificação , Tardígrados/classificação
14.
Commun Biol ; 2: 63, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30793042

RESUMO

Abiotic factors are major determinants of soil animal distributions and their dominant role is pronounced in extreme ecosystems, with biotic interactions seemingly playing a minor role. We modelled co-occurrence and distribution of the three nematode species that dominate the soil food web of the McMurdo Dry Valleys (Antarctica). Abiotic factors, other biotic groups, and autocorrelation all contributed to structuring nematode species distributions. However, after removing their effects, we found that the presence of the most abundant nematode species greatly, and negatively, affected the probability of detecting one of the other two species. We observed similar patterns in relative abundances for two out of three pairs of species. Harsh abiotic conditions alone are insufficient to explain contemporary nematode distributions whereas the role of negative biotic interactions has been largely underestimated in soil. The future challenge is to understand how the effects of global change on biotic interactions will alter species coexistence.


Assuntos
Artrópodes/fisiologia , Nematoides/fisiologia , Rotíferos/fisiologia , Solo/química , Tardígrados/fisiologia , Animais , Regiões Antárticas , Artrópodes/classificação , Biodiversidade , Cianobactérias/classificação , Cianobactérias/fisiologia , Ecossistema , Fungos/classificação , Fungos/fisiologia , Modelos Estatísticos , Nematoides/classificação , Rotíferos/classificação , Solo/parasitologia , Microbiologia do Solo , Tardígrados/classificação
15.
Eur J Clin Nutr ; 2017 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-28832571

RESUMO

BACKGROUND/OBJECTIVES: Zinc is a negative acute-phase reactant; hence, its concentration decreases in the presence of inflammation. There is no current consensus on how to control for the effect of inflammation on serum zinc, which has implications for accurate estimates of population-level zinc status. We aimed to measure the association between inflammation and serum zinc concentrations and to compare the means and the prevalence of zinc deficiency using unadjusted and inflammation-adjusted serum zinc concentrations among Congolese children. SUBJECTS/METHODS: Non-fasting blood was collected in the afternoon in trace element-free vacutainers from 744 apparently healthy children aged 6-59 months in the Democratic Republic of the Congo. Serum was analyzed for zinc, C-reactive protein (CRP) and α-1 acid glycoprotein (AGP) for 665 children with complete data for all three biomarkers. Linear regression was used to generate correction factors (CFs) based on three stages of inflammation: incubation (CRP >5 mg/l and normal AGP), early convalescence (CRP >5 mg/l and AGP >1 g/l) and late convalescence (AGP >1 g/l and normal CRP), relative to no inflammation. RESULTS: Overall unadjusted mean±s.d. serum zinc concentration was 9.4±2.1 µmol/l. Study-generated CFs (95% confidence interval) for incubation, early and late convalescence were 1.01 (0.88, 1.14), 1.15 (1.11, 1.21) and 1.07 (1.03, 1.11), respectively. After applying the CFs, overall adjusted mean±s.d. serum zinc concentration was 10.1±2.2 µmol/l, and prevalence of zinc deficiency (<8.7 µmol/l) decreased from 35% (n=234/665) to 24% (n=160/665). CONCLUSIONS: Adjustment of zinc concentrations for inflammation is warranted when assessing population-level zinc status.European Journal of Clinical Nutrition advance online publication, 23 August 2017; doi:10.1038/ejcn.2017.127.

16.
Int J Lab Hematol ; 39(1): 95-100, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27997764

RESUMO

INTRODUCTION: Hemoglobin (Hb) concentration is often measured in global health and nutrition surveys to determine anemia prevalence using a portable hemoglobinometer such as the Hemocue® Hb 201+. More recently, a newer model was released (Hemocue Hb 301) utilizing slightly different methods to measure Hb as compared to the older model. The objective was to measure bias and concordance between Hb concentrations using the Hemocue Hb 301 and Hb 201+ models in a rural field setting. METHODS: Hemoglobin (Hb) concentration was measured using one finger prick of blood (approximately 10 µL) from 175 Cambodian women (18-49 years) using three Hemocue Hb 201+ and three Hb 301 machines. Bias and concordance were measured and plotted. RESULTS: Overall, mean ± SD Hb concentration was 116 ± 13 g/L using the Hb 201+ and 118 ± 12 g/L using the Hb 301; and anemia prevalence (Hb < 120 g/L) was 58% (n = 102) and 58% (n = 101), respectively. Overall bias ± SD was 2.0 ± 10.5 g/L and concordance (95% CI) was 0.63 (0.54, 0.72). Despite the 2 g/L bias detected between models, anemia prevalence was very similar in both models. CONCLUSIONS: The two models measured anemia prevalence comparably in this population of women in rural Cambodia.


Assuntos
Anemia/sangue , Hemoglobinas/metabolismo , Anemia/epidemiologia , Camboja/epidemiologia , Feminino , Hemoglobinometria/instrumentação , Humanos , Prevalência
17.
Leukemia ; 31(4): 934-944, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-27740635

RESUMO

Most myeloproliferative neoplasm (MPN) patients lacking JAK2 mutations harbour somatic CALR mutations that are thought to activate cytokine signalling although the mechanism is unclear. To identify kinases important for survival of CALR-mutant cells, we developed a novel strategy (KISMET) that utilizes the full range of kinase selectivity data available from each inhibitor and thus takes advantage of off-target noise that limits conventional small-interfering RNA or inhibitor screens. KISMET successfully identified known essential kinases in haematopoietic and non-haematopoietic cell lines and identified the mitogen activated protein kinase (MAPK) pathway as required for growth of the CALR-mutated MARIMO cells. Expression of mutant CALR in murine or human haematopoietic cell lines was accompanied by myeloproliferative leukemia protein (MPL)-dependent activation of MAPK signalling, and MPN patients with CALR mutations showed increased MAPK activity in CD34 cells, platelets and megakaryocytes. Although CALR mutations resulted in protein instability and proteosomal degradation, mutant CALR was able to enhance megakaryopoiesis and pro-platelet production from human CD34+ progenitors. These data link aberrant MAPK activation to the MPN phenotype and identify it as a potential therapeutic target in CALR-mutant positive MPNs.


Assuntos
Calreticulina/genética , Diferenciação Celular , Megacariócitos/citologia , Megacariócitos/metabolismo , Proteínas Quinases Ativadas por Mitógeno/metabolismo , Mutação , Transdução de Sinais , Antígenos CD34/metabolismo , Calreticulina/antagonistas & inibidores , Linhagem Celular , Descoberta de Drogas , Expressão Ectópica do Gene/efeitos dos fármacos , Sangue Fetal/citologia , Humanos , Janus Quinase 2/antagonistas & inibidores , Janus Quinase 2/genética , Megacariócitos/efeitos dos fármacos , Complexo de Endopeptidases do Proteassoma/metabolismo , Inibidores de Proteínas Quinases/farmacologia , Estabilidade Proteica , Proteínas Proto-Oncogênicas B-raf/genética , Proteínas Proto-Oncogênicas B-raf/metabolismo , Transdução de Sinais/efeitos dos fármacos , Trombopoese/genética , Proteínas ras/genética , Proteínas ras/metabolismo
18.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-666543

RESUMO

Plants toxic to livestock species have a significantly negative impact on agriculture but can be an important source of bioactive molecules for use in medicine. The initial research on plant toxicity is focused on the response to the poisoning and the specific livestock species impacted by the toxic plant. This research emphasizes the identification of the plant and natural product(s) responsible for the toxicity to livestock, the prevention of further poisonings, and the development of treatments for the affected animals. Once the bioactive molecules impacting the livestock species have been identified, research on these compounds is then focused on determining the mechanism of action, the development of models for further study, and the identification of potential drug candidates for the treatment of disease. Specific examples of the agricultural-based research that are relevant to Human and Veterinary Medicine include: cyclopamine from Veratrum californicum (western false hellebore), piperidine alkaloids from Lupinus species (lupines), and cicutoxin from Cicuta species (water hemlock).

19.
J Strength Cond Res ; 30(3): 800-6, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26907844

RESUMO

This study compared acute postexercise oxygen consumption in 11 trained women (age, 46.5 ± 1.6 years; body mass index [BMI], 28.4 ± 1.7 kg·m(-2) and 11 untrained women (age, 46.5 ± 1.5 years; BMI, 27.5 ± 1.5 kg·m(-2)) after resistance exercise (RE). Resistance exercise consisted of 3 sets of 8 exercises (8-12 repetitions at 50-80% 1 repetition maximum). Oxygen consumption (VO2 ml·min(-1)) was measured before and after (0, 20, 40, 60, 90, and 120 minutes) RE. Immediately after cessation of RE (time 0), oxygen consumption increased in both trained and untrained women and remained significantly above baseline through 60 minutes after exercise (p < 0.01). Total oxygen consumption during recovery was 31.3 L in trained women and 27.4 L in untrained women (p = 0.07). In trained women, total oxygen consumption was strongly related to absolute (kg) lean mass (r = 0.88; p < 0.001), relative (kilogram per square meter) lean mass (r = 0.91; p < 0.001), and duration of exercise (r = 0.68; p ≤ 0.05), but in untrained women, only training volume-load was related to total oxygen consumption (r = 0.67; p ≤ 0.05). In trained women, 86% of the variance in oxygen consumption was explained by lean mass and exercise duration, whereas volume-load explained 45% in untrained women. Our findings suggest that, in women, resistance training increases metabolic activity of lean tissue. Postexercise energy costs of RE are determined by the duration of stimulation provided by RE rather than absolute work (volume-load) performed. This phenomenon may be related to type II muscle fibers and increased protein synthesis.


Assuntos
Metabolismo Energético , Consumo de Oxigênio , Condicionamento Físico Humano/fisiologia , Treinamento Resistido , Adulto , Composição Corporal , Feminino , Humanos , Pessoa de Meia-Idade , Músculo Esquelético/fisiologia , Fatores de Tempo
20.
Int Microbiol ; 19(3): 161-173, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28494086

RESUMO

A previously established chronosequence from Pia Glacier forefield in Tierra del Fuego (Chile) containing soils of different ages (from bare soils to forest ones) is analyzed. We used this chronosequence as framework to postulate that microbial successional development would be accompanied by changes in functionality. To test this, the GeoChip functional microarray was used to identify diversity of genes involved in microbial carbon and nitrogen metabolism, as well as other genes related to microbial stress response and biotic interactions. Changes in putative functionality generally reflected succession-related taxonomic composition of soil microbiota. Major shifts in carbon fixation and catabolism were observed, as well as major changes in nitrogen metabolism. At initial microbial dominated succession stages, microorganisms could be mainly involved in pathways that help to increase nutrient availability, while more complex microbial transformations such as denitrification and methanogenesis, and later degradation of complex organic substrates, could be more prevalent at vegetated successional states. Shifts in virus populations broadly reflected changes in microbial diversity. Conversely, stress response pathways appeared relatively well conserved for communities along the entire chronosequence. We conclude that nutrient utilization is likely the major driver of microbial succession in these soils. [Int Microbiol 19(3):161-173 (2016)].


Assuntos
Camada de Gelo/microbiologia , Microbiologia do Solo , Carbono/metabolismo , Ciclo do Carbono , Chile , Ecologia , Nitrogênio/metabolismo , Análise de Sequência com Séries de Oligonucleotídeos
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