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1.
Sci Rep ; 13(1): 16255, 2023 09 27.
Artigo em Inglês | MEDLINE | ID: mdl-37758739

RESUMO

Highly pathogenic avian influenza (HPAI) is continuously causing significant economic losses with massive poultry depopulations. Airborne transmission of HPAI was suspected, as initial bird mortalities were reported near air inlets of poultry houses. In addition, infected farms were distant, indicating that the viruses carried by dust particles might help the viruses travel for long distances in the environment. The objective of this study focused on simulating the airborne transmission of HPAI by using computational modeling to assess the risk of airborne and deposited avian influenza (AI) carried by poultry-litter dust particles. The Hybrid Single-Particle Lagrangian Integrated Trajectory (HYSPLIT) modeling was used in this study. Data from 168 infected cases in the Mid-Western area of U.S. were obtained from the Animal and Plant Health Inspection Service (APHIS) and Watt Poultry. The concentration simulation modeling was performed to estimate the airborne and deposited AI concentration carried by PM2.5 dust particles. Results showed that concentrations of airborne AI, deposited AI, and combined AI transmitted to other farms in a day were lower than the minimal infective dose for poultry. In most of the scenarios, the predicted probability of infection showed that Iowa-infected farms and turkey poultry houses had the highest infection probability. The findings may provide an understanding of the risk of airborne HPAI virus carried by dust particles and suggest the factors that influence long-distance airborne transmission.


Assuntos
Influenza Aviária , Doenças das Aves Domésticas , Animais , Poeira , Aerossóis e Gotículas Respiratórios , Galinhas , Aves Domésticas , Surtos de Doenças/veterinária
2.
Public Health ; 216: 30-32, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36773386

RESUMO

OBJECTIVES: Although there is growing evidence that in utero exposure to power plants increases the risk of adverse birth outcomes, studies have focused on coal-fired plants and single US locations, limiting generalizability. We used birth certificate data from 50 states and DC to examine the associations between prenatal exposure to power plants and birth outcomes overall and by race/ethnicity. METHODS: We linked 2009-2018 county-level microdata natality files on 34,674,911 singleton births from 50 states and DC with 9-month county-level averages of power plant fuel consumption based on month/year of birth. We estimated linear regression models for birth weight and gestational age and probit models for the dichotomous outcomes of low birth weight, small for gestational age (SGA), and preterm birth. We subsequently examined interactions between plant fuel consumption and race/ethnicity. RESULTS: Overall, 69.1% of counties had any power plant fuel consumption. Although we found no overall effects of prenatal exposure to power plants on birth weight or SGA, a significant interaction (both P < 0.01) revealed that a 10% increase in fuel consumption was associated with infants born to White women having slightly lower birth weights (1.76 g; 95% confidence interval = -2.87, -0.65) and higher risk of being born SGA (0.0002; 95% confidence interval = 0.0002, 0.0002). CONCLUSION: Power plants have negative effects on infant health, which exist independent of locality.


Assuntos
Nascimento Prematuro , Efeitos Tardios da Exposição Pré-Natal , Gravidez , Lactente , Recém-Nascido , Humanos , Estados Unidos , Feminino , Resultado da Gravidez , Peso ao Nascer , Centrais Elétricas
3.
Animal ; 17(1): 100692, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36584623

RESUMO

Lameness in broilers may be associated with pain and is considered a major broiler production and welfare concern. Manual gait score assessment in commercial broiler houses is discrete, time-consuming, and laborious. As such, automatic methods for broiler gait score assessment are urgently needed. The objective of this study was to identify the relation of broiler gait score with several productions and behavioral metrics (bird BW, age, activity, and distribution), and establish three gait score prediction models for automatic gait score estimations in broiler farms with automatic weighing systems, camera systems, or both. Sixteen pens were used to rear Cobb 500 and Ross 708 broilers for eight and nine weeks, respectively (eight pens/strain, 12 birds/pen). The gait scores of all birds were assessed weekly by trained assessors following a six-point (0-5) scoring protocol from the third week. The pen's average BW was measured weekly. Top-view cameras were installed to continuously record videos of broilers in all 16 pens. Images were extracted from video clips (10 min/hour) during a 16-hour light period to determine the activity index and distribution index through image processing. The gait score was positively correlated with BW (R2 = 0.97 for Cobb and R2 = 0.96 for Ross), while negatively correlated with activity (R2 = 0.78 for Cobb and R2 = 0.73 for Ross). The three models showed high accuracies in predicting broiler gait score based on variables of BW, age, activity index, and distribution index (R2 = 0.90-0.91, RMSE = 0.38-0.41). The findings of this study demonstrated the potential of estimating broiler gait score using bird BW, age, activity index, and distribution index. This information will assist in the development of automated gait score assessment systems in broiler production.


Assuntos
Galinhas , Marcha , Animais , Processamento de Imagem Assistida por Computador
4.
Ann Med Surg (Lond) ; 81: 104503, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36147051

RESUMO

Background: When evaluating trauma patients, many centers perform computed tomography of the head, cervical spine, chest, abdomen, and pelvis, the so-called "pan-scan." Here, we evaluate the utility of physical exam against pan-scan in geriatric patients who sustained ground-level falls. Methods: We performed a single-centered retrospective cohort review of consecutive patients from the trauma registry of a large, urban Level 1 trauma center. Inclusion criteria were registration during the 2019 calendar year, age ≥65, mechanism of fall from either sitting or standing, and performance of "pan-scan" at time of assessment. The sensitivity, specificity, positive and negative predictive values of the physical exam for significant injuries were calculated. The effect of such injuries on disposition from the emergency department and hospital were determined. Results: An initial query for patients age ≥65 yielded 1280 patients. After exclusion of patients who did not undergo pan-scan or who had GCS <14, 751 patients were included in analysis. Median age was 84 years old. 351 patients had at least one injury identified on pan-scan. Physical exam was determined to have a sensitivity of 0.69 when compared to pan-scan as a gold standard. Patients with injury identified on CT scan had significantly more admissions, mortalities, and ICU and OR requirements. Conclusion: Approximately half of all patients were found to have at least one injury on pan-scan. Physical examination was insensitive at identifying such injuries which ultimately altered patient management, disposition, and outcomes. Pan-scan is recommended in this vulnerable population.

5.
Mar Environ Res ; 172: 105485, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34715642

RESUMO

AIMS: Rising sea-level following the Last Glacial Maximum lead to fragmentation of coastal limpet populations between islands of the Archipelago of Madeira. This fragmentation is reinforced by recent heavy exploitation reducing effective population size on Madeira Island. We use the limpet P. aspera to understand how the role of processes at different time scales (i.e. changes in the sea level and overexploitation) can influence the genetic composition of an extant species, relating these processes to reproductive phenology and seasonal shifts in ocean currents. LOCATION: Madeira Island, Porto Santo and Desertas (Archipelago of Madeira, NE Atlantic Ocean). TAXON: The limpet Patella aspera. METHODS: Twelve microsatellite genetic markers were used. A power analysis was used to evaluate the power of the microsatellite markers to detect a signal of population differentiation. Long-term past migrations were assessed using a Bayesian Markov Montecarlo approach in the software MIGRATE-n to estimate mutation-scaled migration rates (M = m/µ; m, probability of a lineage immigrating per generation; µ, mutation rate). Two scenarios were evaluated using an Approximate Bayesian Computation (ABC) in the software DIYABC 2.1 (i) Scenario 1: considered a population scenario from a reduced Ne at time t3 to a higher Ne at time t2; and (ii) Scenario 2 considering a reduction of Ne from a time t3 to a time t2. RESULTS: Colonization of the archipelago by Portuguese settlers six centuries ago probably led to an important decrease in the genetic diversity of the species (Ne). Contemporary gene flow strongly support a pattern of high asymmetric connectivity explained by the reproductive phenology of the species and spatio-temporal seasonal changes in the ocean currents. Spatio-temporal reconstructions using Bayesian methods, including coalescent and Approximate Bayesian Computation (ABC) approaches, suggest changes in the migration patterns from highly symmetric to highly asymmetric connectivity with subtle population differentiation as consequence of post-glacial maximum sea level rise during the Holocene. MAIN CONCLUSIONS: Our results suggest that anthropogenic activity could have had serious effects on the genetic diversity of heavily exploited littoral species since the end of the Pleistocene, probably accelerating in recent years.


Assuntos
Variação Genética , Patela , Oceano Atlântico , Teorema de Bayes , Genética Populacional , Portugal
7.
Mar Pollut Bull ; 156: 111150, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32510354

RESUMO

For much of the 20th century, the Mersey in North West England was one of the worst polluted estuaries in Europe. Water from a range of polluting industries plus domestic sewage was discharged into the Mersey Catchment and Estuary. Recovery came through a concerted clean-up campaign and tightening environmental regulations, partly driven by European Commission Directives, coupled with de-industrialisation from the 1970s onward. Recovery of oxygen levels in the Estuary led to the return of a productive ecosystem. This led to conservation designations, but also concerns about transfer of pollutants to higher trophic levels in fish, birds and humans. As part of urban renewal, ecosystems in disused dock basins were restored using mussel biofiltration and artificial de-stratification, facilitating commercial redevelopment and creation of a tourist destination. The degradation and recovery of the Mersey from peak-pollution in the mid-20th century is put in the context of wider environmental change and briefly compared to other systems to develop a hysteresis model of degradation and recovery, often to novel ecosystems.


Assuntos
Estuários , Poluentes Químicos da Água/análise , Animais , Ecossistema , Inglaterra , Monitoramento Ambiental , Europa (Continente) , Humanos , Esgotos
8.
Int J Cosmet Sci ; 39(6): 589-599, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28733999

RESUMO

OBJECTIVE: To evaluate a combination of retinyl propionate and climbazole (RPC) compared to 0.1% retinol for its efficacy, tolerance and ageing appearance. METHOD: Forty-five healthy Caucasian females, ages 40-70, with moderately photodamaged facial skin, were recruited for a 16-week randomized, double-blind, IRB-approved facial study. The efficacy of RPC treatment was compared to 0.1% retinol, in the same product base formulation, with twice daily, split-face product application. Changes in overall photodamage, fine lines and wrinkles, pigmentation and irritation were visually evaluated and measured by instrumentation. Subjective appraisal of efficacy was self-assessed from images where subjects were blinded to treatment and time point. Irritancy potential was also evaluated in a 5-day randomized, double-blind, IRB-approved patch study. RESULTS: Treatment with RPC resulted in significant (P < 0.05) improvement in ageing attributes compared to 0.1% retinol treatment, with minimal irritation. More than 50% of subjects showed improvement to deep wrinkles in the crow's feet area after 5 weeks of product application, and continued improvement to deep wrinkles was observed throughout the course of the study. Similarly, improvement was observed for the appearance of lines and wrinkles in the nasolabial fold (NLF) and for mottled hyperpigmentation. The results from subjective self-assessment confirmed in vivo clinical assessments. In a separate patch study, significantly less irritation was observed with the RPC product as compared to the 0.1% retinol control product. CONCLUSION: RPC delivered significant skin anti-ageing benefits comparable or greater than 0.1% retinol, with minimal irritation.


Assuntos
Hiperpigmentação/tratamento farmacológico , Imidazóis/administração & dosagem , Envelhecimento da Pele/efeitos dos fármacos , Vitamina A/análogos & derivados , Adulto , Diterpenos , Método Duplo-Cego , Quimioterapia Combinada , Feminino , Humanos , Imidazóis/efeitos adversos , Masculino , Pessoa de Meia-Idade , Ésteres de Retinil , Vitamina A/administração & dosagem , Vitamina A/efeitos adversos , Adulto Jovem
9.
Mar Pollut Bull ; 124(2): 573-586, 2017 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-28314615

RESUMO

Marine ecosystems are subject to anthropogenic change at global, regional and local scales. Global drivers interact with regional- and local-scale impacts of both a chronic and acute nature. Natural fluctuations and those driven by climate change need to be understood to diagnose local- and regional-scale impacts, and to inform assessments of recovery. Three case studies are used to illustrate the need for long-term studies: (i) separation of the influence of fishing pressure from climate change on bottom fish in the English Channel; (ii) recovery of rocky shore assemblages from the Torrey Canyon oil spill in the southwest of England; (iii) interaction of climate change and chronic Tributyltin pollution affecting recovery of rocky shore populations following the Torrey Canyon oil spill. We emphasize that "baselines" or "reference states" are better viewed as envelopes that are dependent on the time window of observation. Recommendations are made for adaptive management in a rapidly changing world.


Assuntos
Mudança Climática , Pesqueiros , Poluição por Petróleo , Poluição da Água , Animais , Ecossistema , Ecotoxicologia/métodos , Inglaterra , Meio Ambiente , Peixes , Biologia Marinha/métodos , Compostos de Trialquitina/toxicidade , Poluentes Químicos da Água/toxicidade
10.
Int J Cosmet Sci ; 39(4): 411-418, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28103388

RESUMO

OBJECTIVE: To explore whether climbazole enhances retinoid-associated biological activities in vitro and in vivo. METHODS: Primary human dermal fibroblasts (HDFs) were treated from six to 48 h with either retinoids (retinol, retinyl propionate, retinyl palmitate) alone or in combination with climbazole, and then assessed for cellular retinoic acid-binding protein 2 (CRABP2) mRNA expression by RT-qPCR. Next, skin equivalent (SE) cultures were topically treated with retinol or retinyl propionate, with or without climbazole, and then measured for biological changes in retinoid biomarkers. Lastly, an IRB-approved clinical study was conducted on the outer forearm of 16 subjects to ascertain the effects of low (0.02%) or high (0.1%) levels of retinol, retinyl propionate (0.5%), climbazole (0.5%) or a combination of retinol (0.02%)/climbazole (0.5%). Indicators of retinoid activities were measured after 3 weeks. RESULTS: Treatment of HDFs with retinol or retinyl propionate was unaffected by climbazole but alone, resulted in a significantly (P < 0.01) higher sustained CRABP2 mRNA expression than those treated with retinyl palmitate or vehicle control. In SEs, climbazole combined with either retinol or retinyl propionate boosted retinoid related activity greater than the retinoid only, reflected by a dose-response, downregulation of loricrin (LOR) and induction of keratin 4 (KRT4) proteins. In vivo, retinol (0.1%) and retinyl propionate (0.5%) significantly increased most evaluated biomarkers, as expected. Low-dose retinol or climbazole alone did not increase these biomarkers; however, in combination, significant (P < 0.05) increases in retinoid and ageing biomarkers were detected. CONCLUSION: Climbazole boosted retinoid activity both in the SE model, after a combined topic treatment with either retinol or retinyl propionate, and in vivo, in combination with a low level of retinol. Based upon the evidence presented here, we suggest that the topical skin application of climbazole in combination with retinoids could deliver skin ageing benefits more than a less robust retinoid alone.


Assuntos
Imidazóis/farmacologia , Retinoides/farmacologia , Pele/efeitos dos fármacos , Adulto , Método Duplo-Cego , Feminino , Humanos , RNA Mensageiro/genética , Reação em Cadeia da Polimerase em Tempo Real , Receptores do Ácido Retinoico/genética , Pele/citologia
11.
Eur J Surg Oncol ; 43(1): 62-67, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27667335

RESUMO

INTRODUCTION: Wire guided localisation (WGL) is the standard localisation technique for impalpable breast lesions. Radio-guided occult lesion localisation (ROLL) has been proposed as an alternative. We have been performing ROLL for therapeutic wide local excisions (WLE) and diagnostic excision biopsies (DEB) for the last 15 years. We present the largest reported consecutive series of ROLL excisions to date. PATIENTS AND METHODS: One thousand thirty nine consecutive patients who underwent ROLL for impalpable breast lesions were identified from a prospectively collected database. 673 patients underwent WLE and 366 patients underwent DEB. Data were analysed from proformas completed at the time of the procedure by the radiologist and operating surgeon. These data were supplemented with an analysis of patient electronic records including specimen radiograph and histopathology reports. RESULTS: 99.1% of ROLL WLE revealed histological diagnoses of invasive cancer or DCIS. 98.7% of radiological abnormalities were identified on WLE post-excision radiographs (97.5% following DEB). Complete excision was recorded in 79.0% of the WLE patients following histological evaluation. 31.7% of DEB cases were pathologically upgraded to a malignant diagnosis. The presence of microcalcification, preoperative underestimation of the lesion size and symptomatic referral predisposed to incomplete excision status. DISCUSSION: ROLL is a safe and effective technique to localise impalpable breast lesions. In addition ROLL has potential technical and logistic advantages over WGL.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Feminino , Humanos , Mamografia , Mastectomia Segmentar , Pessoa de Meia-Idade , Invasividade Neoplásica , Palpação , Estudos Prospectivos , Radioisótopos , Biópsia de Linfonodo Sentinela , Agregado de Albumina Marcado com Tecnécio Tc 99m , Ultrassonografia Mamária
12.
Public Health ; 138: 119-26, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27207726

RESUMO

BACKGROUND AND OBJECTIVES: Despite recognised disparities in child health outcomes associated with sleep, the majority of research has been based on small, homogeneous samples. Using a nationally-representative sample of US children and adolescents, we examined trends and social determinants of inadequate sleep across age groups. STUDY DESIGN: Comparison of cross-sectional studies. METHODS: Our study used the 2003 (n = 68,418), 2007 (n = 63,442), and 2011/2012 (n = 65,130) waves of the National Survey of Children's Health, a nationally-representative survey of 6-17-year-olds. Parents reported whether the child had inadequate sleep (0-6 days of not getting enough sleep vs 7 days). RESULTS: From 2003 through 2011/12, inadequate sleep increased from 23 to 36% among 6-9-year-olds, 30 to 41% among 10-13-year-olds, and 41 to 49% among 14-17-year-olds. Among 10-17-year-olds, those from households with more than a high school degree were more likely to have inadequate sleep (adjusted ORs 1.2). Although for 10-13-year-olds there was a gradient in inadequate sleep across income (aORs 1.2-1.3), for 14-17-year-olds, only those from the two highest income levels were more likely to have inadequate sleep (aORs 1.3-1.4). Parents' reports that neighbours did not watch out for other's children was associated with an increased risk for inadequate sleep across all ages (aORs 1.1-1.3). CONCLUSIONS: Inadequate sleep occurred as young as age six years and increased with age, became more prevalent, and was socially patterned. In order to prevent inadequate sleep across the life course, surveillance and monitoring are needed across all age groups to identify critical periods for intervention.


Assuntos
Privação do Sono/epidemiologia , Determinantes Sociais da Saúde , Adolescente , Criança , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Fatores de Risco , Fatores Socioeconômicos , Estados Unidos/epidemiologia
13.
Curr Mol Med ; 16(3): 288-98, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26917261

RESUMO

Our previous whole genome expression analysis of endometriomas suggested dysregulation of the ten-eleven translocation genes (TET1, TET2, and TET3), involved in converting 5- methylcytosine to 5-hydroxymethylcytosine (5-hmC). The objective of this study was to validate the expression of TET genes in ectopic and eutopic endometrium and in primary cultures of human endometrial stromal fibroblasts (HESF) during in vitro decidualization and to quantify 5-hmC levels in patients with endometriosis. Blood, eutopic endometrium, and endometriotic tissues were collected at time of gynecologic surgery. HESF cultures were created from eutopic endometrium of women without (HESF-CONTROL) and with endometriosis (HESF-ENDO) and underwent in vitro decidualization. Genomic DNA from blood and tissues underwent quantification of the absolute amount of 5-hmC using ELISA. The expression of TET1, TET2, and TET3 was decreased in endometriosis compared to non-endometriosis control eutopic endometrium. Surprisingly, the global amount of 5-hmC was higher in ectopic endometrium than control eutopic endometrium, while genomic DNA from blood of women with endometriosis contained statistically significantly less 5-hmC than women without endometriosis. Expression of TET1, TET2, and TET3 was decreased in non-decidualized HESFENDO. Upon in vitro decidualization, control HESF showed decreased expression of TET3, while decidualized HESF-ENDO showed no statistically significant change in expression of TET1, TET2, or TET3. These results indicate that the TET genes are downregulated in ectopic endometrium and in HESF-ENDO, and suggest for the first time that TET genes play a role in endometriosis. High global amounts of 5-hmC in endometriotic tissues suggest unique epigenetic regulation in these tissues.


Assuntos
Proteínas de Ligação a DNA/genética , Dioxigenases/genética , Endometriose/genética , Endométrio/metabolismo , Epigênese Genética , Oxigenases de Função Mista/genética , Proteínas Proto-Oncogênicas/genética , 5-Metilcitosina/análogos & derivados , Adulto , Idoso , Estudos de Casos e Controles , Citosina/análogos & derivados , Citosina/sangue , Proteínas de Ligação a DNA/metabolismo , Dioxigenases/metabolismo , Endometriose/sangue , Endometriose/patologia , Endometriose/cirurgia , Endométrio/patologia , Feminino , Fibroblastos/metabolismo , Fibroblastos/patologia , Humanos , Histerectomia , Ciclo Menstrual/genética , Pessoa de Meia-Idade , Oxigenases de Função Mista/metabolismo , Cultura Primária de Células , Proteínas Proto-Oncogênicas/metabolismo , Transdução de Sinais , Células Estromais/metabolismo , Células Estromais/patologia
14.
Int J Cosmet Sci ; 38(2): 178-86, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26352535

RESUMO

BACKGROUND: Corneosurfametry (CSM) was originally developed as a tool to predict irritation potential of cleansers. In this method, surface skin stripped using cyanoacrylate is contacted with surfactants/products, rinsed and stained with toluidine blue and basic fuschin dyes. The intensity of staining increases with increases in irritation potential of surfactant. Our objective was to modify the CSM technique to achieve better control of the tape stripping process. Another objective was to correlate the modified CSM (MCSM) with a traditional in-vivo forearm controlled application test (FCAT) for mildness and to explore its utility to assess the state of corneum after a clinical test. METHODS: Surface skin cells were tape stripped from forearms of volunteers with D-Squame Adhesive Discs. Discs were treated with a 10% solution of the product in a 96-plate well for 10 min, rinsed, dried and treated with basic fuschin-toluidine blue dye solution, rinsed and dried again. Forearm Controlled Application Test (FCAT) was based on a published protocol. Tape strips obtained after product treatment were also analyzed by the MCSM procedure without additional product treatment. RESULTS: Mildness/barrier damage assessed from in-vivo FCAT showed a similar ranking to the MCSM results. MCSM, TEWL and Erythema analysis of between-treatment differences showed a good correlation indicating that barrier damage seen in in-vivo studies can be predicted from ex-vivo MCSM studies. MCSM analysis of tape strips after the FCAT study showed that the damage decreased with increase in tape strip number. A moisturizing body wash (MBW) with mild surfactants showed the least damage in all layers. In contrast, harsh dish washing liquid showed significantly higher damage down to several layers. Another MBW with petrolatum in a harsher base showed damage almost similar to that of the harsh dish washing liquid in the surface layers. Thus, the MCSM was able to show underlying damage which would have been normally masked by the deposited petrolatum. CONCLUSION: The MCSM assay was shown to be a valuable tool for accelerated high throughput evaluation of mildness of surfactants and fully formulated products. MCSM can also be used to assess the state of the corneum after a product treatment.


Assuntos
Epiderme/efeitos dos fármacos , Adolescente , Adulto , Idoso , Colorimetria , Humanos , Técnicas In Vitro , Irritantes/farmacologia , Pessoa de Meia-Idade , Adulto Jovem
16.
Neurocrit Care ; 23(3): 307-12, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26209280

RESUMO

BACKGROUND: The primary objectives of this study were to identify patient and community benefits of mandatory intensivist management in a neurocritical care (NCC) unit. Our hospital recently mandated intensivist management for patients admitted to the NCC unit. As one of the only comprehensive stroke centers in Orlando, an unacceptably high number of patients were being denied admission because of overcapacity. We compared length of stay (LOS), complications, outcomes, total admissions, and emergency transfer center closure rates before and after implementation of mandatory intensivist management. METHODS: A retrospective review comparing 1551 patients admitted to a 20 bed NCC unit from November 1, 2009 to October 31, 2010 (prior to mandatory intensivist management) with 1702 patients admitted from January 1, 2011 to December 31, 2011 (after the requirement) was performed. This included examining LOS, Acute Physiology and Chronic Health Evaluation III (APACHE) scores, service line closure rates, and mortality during both time periods. RESULTS: Analysis revealed that despite comparable APACHE scores, implementation of mandatory intensivist management reduced overall NCC LOS, 4.6 versus 3.7 days, (p < 0.01) and increased the number of monthly admissions, 129 versus 142, (p = 0.02). The percentage of patients declined admission because of a closed service line was reduced from 12.36 to 5.66 %, (p = 0.02). Mortality and infection rates remained unchanged. CONCLUSIONS: Implementation of mandatory intensivist management in the NCC unit decreased LOS, increased admissions, and decreased service line closure rates, while maintaining patient care.


Assuntos
Cuidados Críticos/estatística & dados numéricos , Unidades de Terapia Intensiva/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Doenças do Sistema Nervoso/terapia , Avaliação de Resultados em Cuidados de Saúde/estatística & dados numéricos , Admissão do Paciente/estatística & dados numéricos , Qualidade da Assistência à Saúde/estatística & dados numéricos , APACHE , Mortalidade Hospitalar , Humanos , Doenças do Sistema Nervoso/mortalidade , Estudos Retrospectivos
17.
Opt Express ; 23(5): 6228-38, 2015 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-25836844

RESUMO

We present a half-plane surface-integral equation (SIE) approach for modeling the optical phase response of a single nanowire under phase-stepping interferometric (PSI) microscopy. This approach calculates scattered fields exactly from the Helmholtz equation in this 2D problem, obviating the need for ray-optic approximations. It is demonstrated that refractive index metrology is enabled by this method, with precision as low as 7 × 10(-5) possible for current state-of-the-art PSI microscopes. For nanowires of known refractive index, radii as small as 0.001λ are shown to yield a measurable phase signal and are therefore potentially measurable by this approach. Measurements are also demonstrated to be relatively insensitive to the spectral and coherence characteristics of the light source, the illumination conditions, and variations in nanowire cross-section shape. Prospects for measuring both the radius and refractive index simultaneously, and scope for generalizing this approach to arbitrary nanoparticle shapes are discussed.

19.
J Comp Pathol ; 152(1): 28-40, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25435510

RESUMO

The onset and distribution of infectivity and disease-specific prion protein (PrP(d)) accumulation was studied in Romney and Suffolk sheep of the ARQ/ARQ, ARQ/ARR and ARR/ARR prion protein gene (Prnp) genotypes (where A stands for alanine, R for arginine and Q for glutamine at codons 136, 154 and 171 of PrP), following experimental oral infection with cattle-derived bovine spongiform encephalopathy (BSE) agent. Groups of sheep were killed at regular intervals and a wide range of tissues taken for mouse bioassay or immunohistochemistry (IHC), or both. Bioassay results for infectivity were mostly coincident with those of PrP(d) detection by IHC both in terms of tissues and time post infection. Neither PrP(d) nor infectivity was detected in any tissues of BSE-dosed ARQ/ARR or ARR/ARR sheep or of undosed controls. Moreover, four ARQ/ARQ Suffolk sheep, which were methionine (M)/threonine heterozygous at codon 112 of the Prnp gene, did not show any biological or immunohistochemical evidence of infection, while those homozygous for methionine (MARQ/MARQ) did. In MARQ/MARQ sheep of both breeds, initial PrP(d) accumulation was identified in lymphoreticular system (LRS) tissues followed by the central nervous system (CNS) and enteric nervous system (ENS) and finally by the autonomic nervous system and peripheral nervous system and other organs. Detection of infectivity closely mimicked this sequence. No PrP(d) was observed in the ENS prior to its accumulation in the CNS, suggesting that ENS involvement occurred simultaneously to that of, or followed centrifugal spread from, the CNS. The distribution of PrP(d) within the ENS further suggested a progressive spread from the ileal plexus to other ENS segments via neuronal connections of the gut wall. Differences between the two breeds were noted in terms of involvement of LRS and ENS tissues, with Romney sheep showing a more delayed and less consistent PrP(d) accumulation than Suffolk sheep in such tissues. Whether this accounted for the slight delay (∼5 months) in the appearance of clinical signs in Romney sheep is debatable since by the last scheduled kill before animals reached clinical end point, both breeds showed widespread accumulation and similar magnitudes of PrP(d) accumulation in the brain.


Assuntos
Encefalopatia Espongiforme Bovina/genética , Encefalopatia Espongiforme Bovina/patologia , Proteínas PrPC/metabolismo , Doenças dos Ovinos/genética , Doenças dos Ovinos/patologia , Animais , Bovinos , Encefalopatia Espongiforme Bovina/transmissão , Genótipo , Imuno-Histoquímica , Camundongos , Ovinos , Doenças dos Ovinos/transmissão , Carneiro Doméstico
20.
Philos Trans A Math Phys Eng Sci ; 372(2025)2014 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-25157190

RESUMO

Marine biodiversity currently faces unprecedented threats from multiple pressures arising from human activities. Global drivers such as climate change and ocean acidification interact with regional eutrophication, exploitation of commercial fish stocks and localized pressures including pollution, coastal development and the extraction of aggregates and fuel, causing alteration and degradation of habitats and communities. Segregating natural from anthropogenically induced change in marine ecosystems requires long-term, sustained observations of marine biota. In this review, we outline the history of biological recording in the coastal and shelf seas of the UK and Ireland and highlight where sustained observations have contributed new understanding of how anthropogenic activities have impacted on marine biodiversity. The contributions of sustained observations, from those collected at observatories, single station platforms and multiple-site programmes to the emergent field of multiple stressor impacts research, are discussed, along with implications for management and sustainable governance of marine resources in an era of unprecedented use of the marine environment.


Assuntos
Organismos Aquáticos , Biodiversidade , Biologia Marinha/métodos , Clima , Humanos , Políticas , Fatores de Tempo , Reino Unido
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