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1.
Entropy (Basel) ; 26(3)2024 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-38539724

RESUMO

A unifying setup for opinion models originating in statistical physics and stochastic opinion dynamics are developed and used to analyze election data. The results are interpreted in the light of political theory. We investigate the connection between Potts (Curie-Weiss) models and stochastic opinion models in the view of the Boltzmann distribution and stochastic Glauber dynamics. We particularly find that the q-voter model can be considered as a natural extension of the Zealot model, which is adapted by Lagrangian parameters. We also discuss weak and strong effects (also called extensive and nonextensive) continuum limits for the models. The results are used to compare the Curie-Weiss model, two q-voter models (weak and strong effects), and a reinforcement model (weak effects) in explaining electoral outcomes in four western democracies (United States, Great Britain, France, and Germany). We find that particularly the weak effects models are able to fit the data (Kolmogorov-Smirnov test) where the weak effects reinforcement model performs best (AIC). Additionally, we show how the institutional structure shapes the process of opinion formation. By focusing on the dynamics of opinion formation preceding the act of voting, the models discussed in this paper give insights both into the empirical explanation of elections as such, as well as important aspects of the theory of democracy. Therefore, this paper shows the usefulness of an interdisciplinary approach in studying real world political outcomes by using mathematical models.

2.
Redox Biol ; 71: 103107, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38479224

RESUMO

Fibroblast growth factor 23 (FGF23) is a member of endocrine FGF family, along with FGF15/19 and FGF21. Recent reports showed that under pathological conditions, liver produces FGF23, although the role of hepatic FGF23 remains nebulous. Here, we investigated the role of hepatic FGF23 in alcoholic liver disease (ALD) and delineated the underlying molecular mechanism. FGF23 expression was compared in livers from alcoholic hepatitis patients and healthy controls. The role of FGF23 was examined in hepatocyte-specific knock-out (LKO) mice of cannabinoid receptor type 1 (CB1R), estrogen related receptor γ (ERRγ), or FGF23. Animals were fed with an alcohol-containing liquid diet alone or in combination with ERRγ inverse agonist. FGF23 is mainly expressed in hepatocytes in the human liver, and it is upregulated in ALD patients. In mice, chronic alcohol feeding leads to liver damage and induced FGF23 in liver, but not in other organs. FGF23 is transcriptionally regulated by ERRγ in response to alcohol-mediated activation of the CB1R. Alcohol induced upregulation of hepatic FGF23 and plasma FGF23 levels is lost in ERRγ-LKO mice, and an inverse agonist mediated inhibition of ERRγ transactivation significantly improved alcoholic liver damage. Moreover, hepatic CYP2E1 induction in response to alcohol is FGF23 dependent. In line, FGF23-LKO mice display decreased hepatic CYP2E1 expression and improved ALD through reduced hepatocyte apoptosis and oxidative stress. We recognized CBIR-ERRγ-FGF23 axis in facilitating ALD pathology through hepatic CYP2E1 induction. Thus, we propose FGF23 as a potential therapeutic target to treat ALD.


Assuntos
Citocromo P-450 CYP2E1 , Hepatopatias Alcoólicas , Animais , Humanos , Camundongos , Citocromo P-450 CYP2E1/genética , Citocromo P-450 CYP2E1/metabolismo , Agonismo Inverso de Drogas , Etanol/farmacologia , Hepatócitos/metabolismo , Fígado/metabolismo , Hepatopatias Alcoólicas/metabolismo , Estresse Oxidativo
3.
BMC Ecol Evol ; 24(1): 35, 2024 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-38493125

RESUMO

The Arnstadt Formation of Saxony-Anhalt, Germany has yielded some of Germany's most substantial finds of Late Triassic tetrapods, including the sauropodomorph Plateosaurus and the stem-turtle Proganochelys quenstedti. Here, we describe an almost complete skull of a new sphenodontian taxon from this formation (Norian, 227-208 Ma), making it the oldest known articulated sphenodontian skull from Europe and one of the oldest in the world. The material is represented by the dermal skull roof and by the complete maxilla and temporal region, as well as parts of the palate, braincase, and lower jaw. A phylogenetic assessment recovers it as a basal sphenodontian closely related to Planocephalosaurus robinsonae and to Eusphenodontia, making it the earliest-diverging sphenodontian known with an articulated skull. Its cranial anatomy is generally similar to the well-known Diphydontosaurus avonis from the Rhaetian of England, showing that this successful phenotype was already established in the clade around 10 myr earlier than assumed. An analysis of evolutionary change rates recovers high rates of evolution in basal sphenodontians, with decreasing rates throughout the evolution of the group. However, contrary to previous studies, reversals in this trend were identified, indicating additional peaks of evolutionary change. These results improve our understanding of the early sphenodontian diversity in Europe, providing critical information on evolutionary trends throughout the history of the clade and sparking renewed interest in its evolution.


Assuntos
Evolução Biológica , Fósseis , Filogenia , Crânio/anatomia & histologia , Alemanha
4.
Int J Mol Sci ; 25(6)2024 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-38542242

RESUMO

Cardiovascular diseases are a significant cause of illness and death worldwide, often resulting in myofibroblast differentiation, pathological remodeling, and fibrosis, characterized by excessive extracellular matrix protein deposition. Treatment options for cardiac fibrosis that can effectively target myofibroblast activation and ECM deposition are limited, necessitating an unmet need for new therapeutic approaches. In recent years, microcurrent therapy has demonstrated promising therapeutic effects, showcasing its translational potential in cardiac care. This study therefore sought to investigate the effects of microcurrent therapy on cardiac myofibroblasts, aiming to unravel its potential as a treatment for cardiac fibrosis and heart failure. The experimental design involved the differentiation of primary rat cardiac fibroblasts into myofibroblasts. Subsequently, these cells were subjected to microcurrent (MC) treatment at 1 and 2 µA/cm2 DC with and without polarity reversal. We then investigated the impact of microcurrent treatment on myofibroblast cell behavior, including protein and gene expression, by performing various assays and analyses comparing them to untreated myofibroblasts and cardiac fibroblasts. The application of microcurrents resulted in distinct transcriptional signatures and improved cellular processes. Gene expression analysis showed alterations in myofibroblast markers, extracellular matrix components, and pro-inflammatory cytokines. These observations show signs of microcurrent-mediated reversal of myofibroblast phenotype, possibly reducing cardiac fibrosis, and providing insights for cardiac tissue repair.


Assuntos
Cardiomiopatias , Miofibroblastos , Ratos , Animais , Miofibroblastos/metabolismo , Miocárdio/metabolismo , Fibroblastos/metabolismo , Coração/fisiologia , Cardiomiopatias/metabolismo , Diferenciação Celular , Fibrose
5.
Environ Res ; 251(Pt 1): 118550, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38432569

RESUMO

INTRODUCTION: Current urban and transport planning practices have significant negative health, environmental, social and economic impacts in most cities. New urban development models and policies are needed to reduce these negative impacts. The Superblock model is one such innovative urban model that can significantly reduce these negative impacts through reshaping public spaces into more diverse uses such as increase in green space, infrastructure supporting social contacts and physical activity, and through prioritization of active mobility and public transport, thereby reducing air pollution, noise and urban heat island effects. This paper reviews key aspects of the Superblock model, its implementation and initial evaluations in Barcelona and the potential international uptake of the model in Europe and globally, focusing on environmental, climate, lifestyle, liveability and health aspects. METHODS: We used a narrative meta-review approach and PubMed and Google scholar databases were searched using specific terms. RESULTS: The implementation of the Super block model in Barcelona is slow, but with initial improvement in, for example, environmental, lifestyle, liveability and health indicators, although not so consistently. When applied on a large scale, the implementation of the Superblock model is not only likely to result in better environmental conditions, health and wellbeing, but can also contribute to the fight against the climate crisis. There is a need for further expansion of the program and further evaluation of its impacts and answers to related concerns, such as environmental equity and gentrification, traffic and related environmental exposure displacement. The implementation of the Superblock model gained a growing international reputation and variations of it are being planned or implemented in cities worldwide. Initial modelling exercises showed that it could be implemented in large parts of many cities. CONCLUSION: The Superblock model is an innovative urban model that addresses environmental, climate, liveability and health concerns in cities. Adapted versions of the Barcelona Superblock model are being implemented in cities around Europe and further implementation, monitoring and evaluation are encouraged. The Superblock model can be considered an important public health intervention that will reduce mortality and morbidity and generate cost savings for health and other sectors.

6.
J Fish Biol ; 2024 Feb 29.
Artigo em Inglês | MEDLINE | ID: mdl-38423514

RESUMO

Two forms of gigantism are differentiated in fish, Brobdingnagian and Goliathan gigantism, the former applying to populations whose individuals are all larger than is typical for the taxon, the latter to single individuals within a population. While Brobdingnagian gigantism is largely explained by various ecological and evolutionary rules, Goliathan gigantism is not. A mechanistic hypothesis is proposed which explains Goliathan gigantism in terms of the reduction of oxygen requirements of individual fish via moving to cooler temperatures and/or acquiring larger, more energy-dense prey, which enable them to get bigger, and, in the process, sometimes generate bimodal size distributions that may qualify as gradual forms between Goliathan and Brobdingnagian gigantism. This mechanism, which relies on the manner in which their gill surface area grows, is more likely to operate in fish that can get big in the first place than in fish that remain small.

7.
PLoS One ; 19(1): e0296986, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38241419

RESUMO

An integrated botanical and chemical approach is used to study surface residues on Funnel Beaker ceramics from the site of Oldenburg LA 77, in northern Germany. Organic residues were discovered adhering to fragments of thick-walled, undecorated ceramic vessels (n = 19) and ceramic discs (n = 2). The surface residues were studied using scanning electron microscopy (SEM), to examine remains of cereals and other plant tissues that survived food preparation and cooking, and using attenuated total reflectance Fourier transform infrared spectroscopy (ATR-FTIR) and direct time-resolved mass spectrometry (DTMS), to chemically identify specific food components. The SEM results show a reoccurring presence of cereal grain (emmer and barley) and one case of co-occurrence of emmer and fat-hen seeds. The SEM evidence for the use of sprouted emmer grain and milk-ripe barley from the Oldenburg residues greatly enhances our understanding of Neolithic foodways in northwestern Europe. The ATR-FTIR results showed that roughly a third of the surface residues contain traces of the original foods prepared or processed and DTMS results confirm that most of the residues primarily contain polysaccharides and a minimal amount of plant protein and that they lack lipids. Only one residue presents minor indications for a (partly) animal origin. The ceramic vessels were thus used almost exclusively for the processing or cooking of cereal grains. This study offers an intimate view of the cuisine and cooking practices (and in some cases their seasonal timing) in an early agricultural village located in a marginal farming region on the south coast of the Baltic Sea.


Assuntos
Galinhas , Grão Comestível , Animais , Feminino , Grão Comestível/química , Cromatografia Gasosa-Espectrometria de Massas , Alemanha , Cerâmica/química
8.
Chemosphere ; 346: 140613, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37944767

RESUMO

The study aims to reveal the exposure to perfluoroalkyl substances (PFAS) in workers in different industry sectors with exposures to hexavalent chromium (Cr(VI)). The PFAS exposure of in total 172 individuals from 4 countries was assessed by the determination of 8 perfluoroalkyl carboxylic acids and 4 perfluoroalkyl sulfonic acids in plasma samples. The participants were 52 chrome plating workers, 43 welders, 3 surface treating workers and 74 workers without any occupational Cr exposure as controls. Significant differences between workers with Cr exposure and controls were found for the perfluoroalkyl sulfonic acids, particularly for perfluorooctane sulfonic acid (PFOS). The median and maximum levels were, respectively, 4.83 and 789 µg/l for chrome plating workers, 4.97 and 1513 µg/l for welders, and 3.65 and 13.9 µg/l for controls. The considerably high PFOS exposure in Cr platers and welders can be explained by the former application of PFOS as mist suppressants in electroplating baths, which resulted in an exposure of the directly involved operators, but also of welders performing maintenance and repair service at these workplaces.


Assuntos
Ácidos Alcanossulfônicos , Fluorocarbonos , Exposição Ocupacional , Humanos , Cromatos , Ferreiros , Ácidos Sulfônicos
11.
Chirurgie (Heidelb) ; 2023 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-38085297

RESUMO

INTRODUCTION: Early postoperative reflux (PR) can compromise anastomotic healing after Ivor Lewis esophagectomy (ILE) and poses a risk for aspiration. Anastomotic insufficiency is the most threatening surgical complication. We present the protective method of pre-emptive active reflux drainage (PARD) with simultaneous enteral feeding. We report our experience with this new safety concept in esophageal surgery in a cohort of 43 patients. MATERIALS AND METHODS: For PARD we use a double lumen open porous film drainage (dOFD). To create the dOFD, the gastric tube of a Trelumina probe (Freka®Trelumina, Fresenius) is coated with a double-layered open-pore drainage film (Suprasorb®CNP drainage film, Lohmann & Rauscher) over a length of 25 cm. The dOFD is endoscopically inserted into the tubular stomach intraoperatively after completion of the anastomosis. Continuous negative pressure is applied with an electronic pump (-125 mm Hg). The PR is continuously aspirated completely and the stomach and anastomotic region are decompressed. At the same time, nutrition is delivered via an integrated intestinal tube. Depending on the results of the endoscopic control after 5 days, PARD is either continued or terminated. RESULTS: During the observation period (2017-2023), PARD was used in all patients (n = 43) with ILE. The healing rate under PARD was 100% and healing was observed in all anastomoses. No additional endoscopic procedures or surgical revisions of the anastomoses were required. The median duration of PARD was 8 days (range 4-21). We observed problems in the healing of the anastomosis in 20 of 43 patients (47%) for whom we defined endoscopic criteria for at-risk anastomosis. CONCLUSIONS: Our results suggest that PARD has a strong protective effect on anastomotic healing and may reduce the risk of anastomotic insufficiency. The integrated feeding tube of the dOFD allows early postoperative enteral feeding while simultaneously applying negative pressure. PARD appears to prevent the negative consequences of impaired anastomotic healing.

12.
Proc Natl Acad Sci U S A ; 120(52): e2312962120, 2023 Dec 26.
Artigo em Inglês | MEDLINE | ID: mdl-38109547

RESUMO

After 500 y of colonizing the forest-steppe area northwest of the Black Sea, on the territories of what is today Moldova and Ukraine, Trypillia societies founded large, aggregated settlements from ca. 4150 BCE and mega-sites (>100 ha) from ca. 3950 BCE. Covering up to 320 ha and housing up to 15,000 inhabitants, the latter were the world's largest settlements to date. Some 480 δ13C and δ15N measurements on bones of humans, animals, and charred crops allow the detection of spatio-temporal patterns and the calculation of complete agricultural Bayesian food webs for Trypillia societies. The isotope data come from settlements of the entire Trypillia area between the Prut and the Dnieper rivers. The datasets cover the development of the Trypillia societies from the early phase (4800-4200/4100 BCE), over the agglomeration of mega-sites (4200/4100-3650 BCE), to the dispersal phase (3650-3000 BCE). High δ15N values mostly come from the mega-sites. Our analyses show that the subsistence of Trypillia mega-sites depended on pulses cultivated on strongly manured (dung-)soils and on cattle that were kept fenced on intensive pastures to easy collect the manure for pulse cultivation. The food web models indicate a low proportion of meat in human diet (approximately 10%). The largely crop-based diet, consisting of cereals plus up to 46% pulses, was balanced in calories and indispensable amino acids. The flourishing of Europe's first mega-populations depended on an advanced, integral mega-economy that included sophisticated dung management. Their demise was therefore not economically, but socially, conditioned [Hofmann et al., PLoS One. 14, e0222243 (2019)].


Assuntos
Agricultura , Isótopos , Animais , Humanos , Bovinos , Teorema de Bayes , Produtos Agrícolas , Produção Agrícola , Esterco/análise , Isótopos de Carbono/análise
13.
J Fish Biol ; 2023 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-37987173

RESUMO

Billfish rostra potentially have several functions; however, their role in feeding is unequivocal in some species. Recent work linked morphological variation in rostral micro-teeth to differences in feeding behavior in two billfish species, the striped marlin (Kajikia audax) and the sailfish (Istiophorus platypterus). Here, we present the rostral micro-tooth morphology for a third billfish species, the blue marlin (Makaira nigricans), for which the use of the rostrum in feeding behavior is still undocumented from systematic observations in the wild. We measured the micro-teeth on rostrum tips of blue marlin, striped marlin, and sailfish using a micro-computed tomography approach and compared the tooth morphology among the three species. This was done after an analysis of video-recorded hunting behavior of striped marlin and sailfish revealed that both species strike prey predominantly with the first third of the rostrum, which provided the justification to focus our analysis on the rostrum tips. In blue marlin, intact micro-teeth were longer compared to striped marlin but not to sailfish. Blue marlin had a higher fraction of broken teeth than both striped marlin and sailfish, and broken teeth were distributed more evenly on the rostrum. Micro-tooth regrowth was equally low in both marlin species but higher in sailfish. Based on the differences and similarities in the micro-tooth morphology between the billfish species, we discuss potential feeding-related rostrum use in blue marlin. We put forward the hypothesis that blue marlin might use their rostra in high-speed dashes as observed in striped marlin, rather than in the high-precision rostral strikes described for sailfish, possibly focusing on larger prey organisms.

14.
J R Soc Interface ; 20(208): 20230409, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37989228

RESUMO

We adopt a maximum-likelihood framework to estimate parameters of a stochastic susceptible-infected-recovered (SIR) model with contact tracing on a rooted random tree. Given the number of detectees per index case, our estimator allows to determine the degree distribution of the random tree as well as the tracing probability. Since we do not discover all infectees via contact tracing, this estimation is non-trivial. To keep things simple and stable, we develop an approximation suited for realistic situations (contract tracing probability small, or the probability for the detection of index cases small). In this approximation, the only epidemiological parameter entering the estimator is R0. The estimator is tested in a simulation study and is furthermore applied to COVID-19 contact tracing data from India. The simulation study underlines the efficiency of the method. For the empirical COVID-19 data, we compare different degree distributions and perform a sensitivity analysis. We find that particularly a power-law and a negative binomial degree distribution fit the data well and that the tracing probability is rather large. The sensitivity analysis shows no strong dependency of the estimates on the reproduction number. Finally, we discuss the relevance of our findings.


Assuntos
COVID-19 , Busca de Comunicante , Humanos , Simulação por Computador , COVID-19/epidemiologia , Probabilidade , Índia/epidemiologia
15.
J Correct Health Care ; 29(6): 439-449, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37930676

RESUMO

Previous research indicates general health benefits of sport for imprisoned individuals. Nevertheless, the role of time spent in sporting activities during imprisonment and the type of sports setting (informal vs. organized) remain unclear. The study uses a quantitative, cross-sectional design. It is based on survey data (N = 568) from the Hessian Prison Sport Study, collected in 12 prisons in Hesse, Germany. By applying regression analyses, the study examines systematic relationships between time spent in sporting activities and incarcerated people's physical, mental, and social health. It also investigates to what extent participation in informal and organized sports is correlated with various health indicators. Results show that higher levels of physical activity (≥5 hours/week) in prison are associated with all health indicators investigated. Incarcerated individuals who regularly engage in informal and organized sports report significantly better health than inactive individuals. Although informal sports yield certain health benefits, only organized sport is associated with higher social connectedness. In addition to confirming the biopsychosocial health benefits of regular sporting activity for imprisoned individuals, the findings highlight that informal and organized sports activities are both important for promoting health.


Assuntos
Prisioneiros , Esportes , Masculino , Humanos , Estudos Transversais , Esportes/psicologia , Exercício Físico/psicologia , Inquéritos e Questionários
16.
Biomedicines ; 11(10)2023 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-37893042

RESUMO

(1) Background: SARS-CoV-2 infection has been linked to diverse clinical manifestations in humans, including cardiovascular complications. Functional autoantibodies targeting G-protein-coupled receptors have emerged as potential contributors to these effects. This study sought to investigate the production and activity of functional autoantibodies targeting G-protein-coupled receptors after SARS-CoV-2 infection of selected animal species. (2) Methods: The presence of functional autoantibodies such as 2-adrenoceptor, angiotensin II AT1 receptor, muscarinic M2 receptor, and angiotensin 1-7 MAS receptor was assessed in cattle and ferrets experimentally infected with SARS-CoV-2. Bioassays were conducted to evaluate the positive or negative chronotropic responses induced by these autoantibodies. Further experiments identified the extracellular domains to which the functional autoantibodies bind, and receptor antagonists were employed to block the induced responses. (3) Results: Only two out of six cattle that were inoculated with SARS-CoV-2 displayed viral replication and tested positive for functional autoantibodies against G-protein-coupled receptors. These functional autoantibodies specifically recognized ß2-adrenoceptor, angiotensin II AT1 receptor, muscarinic M2 receptor, and angiotensin 1-7 MAS receptor and induced distinct positive and negative chronotropic effects in the bioassay. Infected ferrets generated functional autoantibodies against ß2-adrenoceptor and muscarinic M2 receptor and presented bioactivity similar to that in cattle. (4) Conclusions: This study uncovers functional autoantibodies targeting G-protein-coupled receptors in cattle and ferrets post-SARS-CoV-2 infection, with implications for cardiovascular function.

17.
Eur J Investig Health Psychol Educ ; 13(10): 2290-2298, 2023 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-37887163

RESUMO

Organized sports programmes offer manifold opportunities for learning and personal development. Prisoners in organized sports programmes could profit from these educational opportunities, which could eventually support their process of reintegration into society. However, research on the educational experiences of imprisoned individuals during organized sports activities is scarce. Using quantitative survey data (N = 568 adult male prisoners) collected within the scope of the Hessian Prison Sports Study in Hesse, Germany, the present study examines educational experiences that are instigated through participation in five different prison sports programmes (fitness, racket, and team sports, running groups, and strength training). The results show that participants reported few educational experiences. The most common experiences reported were learning to exert effort and acquiring health-related knowledge. The findings reveal distinct patterns for specific sports programmes. For instance, team sports more frequently address cooperation skills and fairness. This paper advocates for more attention to the educational potential of sports in prison settings, where sports outcomes should be better aligned with the desired educational outcomes.

18.
PLoS One ; 18(10): e0291956, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37878565

RESUMO

With their rich Late Neolithic to Early Bronze Age archives, the Circumharz region, the Czech Republic/Lower Austria region, and the Northern Alpine Foreland are well-suited for research on potential links between human activities and climate fluctuations of this period with pronounced archaeological changes. In this paper, we reconstruct the rate and density of the available 14C data from 5500 to 3500 calBP (3550-1550 BCE). We ask to what extent population patterns varied over time and space, and whether fluctuations in human populations and their activities varied with local/regional climate changes. To answer these questions, we have compiled an extensive list of published radiocarbon dates and created 14C sum calibrations for each region. We also compare population dynamics with local and regional palaeoclimate records derived from high-resolution speleothems. At the regional scale, the results suggest a causal relationship between regional climate and population trends. Climate and associated environmental changes were thus at least partly responsible for demographic trends. These results also allow us to question the motivation for the construction of so-called "Early Bronze Age princely tombs" in the Circumharz region during a period of population decline. Among other things, it can be argued that the upper echelons of society may have benefited from trade relations. However, this process was accompanied by ecological stress, a cooling of the winter climate, a decline in the total population and an increase in social inequality.


Assuntos
Radioisótopos de Carbono , Humanos , Animais , Europa (Continente) , Dinâmica Populacional , Estações do Ano
19.
Chirurgie (Heidelb) ; 94(12): 1022-1033, 2023 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-37882839

RESUMO

INTRODUCTION: Early postoperative reflux (PR) can compromise anastomotic healing after Ivor Lewis esophagectomy (ILE) and poses a risk for aspiration. Anastomotic insufficiency is the most threatening surgical complication. We present the protective method of pre-emptive active reflux drainage (PARD) with simultaneous enteral feeding. We report our experience with this new safety concept in esophageal surgery in a cohort of 43 patients. MATERIALS AND METHODS: For PARD we use a double lumen open porous film drainage (dOFD). To create the dOFD, the gastric tube of a Trelumina probe (Freka®Trelumina, Fresenius) is coated with a double-layered open-pore drainage film (Suprasorb®CNP drainage film, Lohmann & Rauscher) over a length of 25 cm. The dOFD is endoscopically inserted into the tubular stomach intraoperatively after completion of the anastomosis. Continuous negative pressure is applied with an electronic pump (-125 mm Hg). The PR is continuously aspirated completely and the stomach and anastomotic region are decompressed. At the same time, nutrition is delivered via an integrated intestinal tube. Depending on the results of the endoscopic control after 5 days, PARD is either continued or terminated. RESULTS: During the observation period (2017-2023), PARD was used in all patients (n = 43) with ILE. The healing rate under PARD was 100% and healing was observed in all anastomoses. No additional endoscopic procedures or surgical revisions of the anastomoses were required. The median duration of PARD was 8 days (range 4-21). We observed problems in the healing of the anastomosis in 20 of 43 patients (47%) for whom we defined endoscopic criteria for at-risk anastomosis. CONCLUSIONS: Our results suggest that PARD has a strong protective effect on anastomotic healing and may reduce the risk of anastomotic insufficiency. The integrated feeding tube of the dOFD allows early postoperative enteral feeding while simultaneously applying negative pressure. PARD appears to prevent the negative consequences of impaired anastomotic healing.


Assuntos
Esofagectomia , Refluxo Gastroesofágico , Humanos , Esofagectomia/efeitos adversos , Endoscopia , Drenagem/efeitos adversos , Drenagem/métodos , Refluxo Gastroesofágico/etiologia , Refluxo Gastroesofágico/prevenção & controle , Refluxo Gastroesofágico/cirurgia
20.
Math Biosci ; 365: 109076, 2023 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-37716407

RESUMO

We investigate the evolutionary dynamics of an age-structured population subject to weak frequency-dependent selection. It turns out that the weak selection is affected in a non-trivial way by the life-history trait. We disentangle the dynamics, based on the appearance of different time scales. These time scales, which seem to form a universal structure in the interplay of weak selection and life-history traits, allow us to reduce the infinite dimensional model to a one-dimensional modified replicator equation. The modified replicator equation is then used to investigate cooperation (the prisoner's dilemma) by means of adaptive dynamics. We identify conditions under which age structure is able to promote cooperation. At the end we discuss the relevance of our findings.

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