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1.
Forensic Sci Int ; 326: 110897, 2021 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-34411937

RESUMO

Diatoms are a useful form of environmental trace evidence, yielding a circumstantial link between persons and scenes of forensic interest. A developing empirical research base has sought to understand those factors affecting the transfer and persistence of freshwater diatoms on clothing and footwear surfaces. Although an initial study has demonstrated that diatoms can persist on clothing following weeks of wear, no previous research has explored the temporal dynamics of a persistent species assemblage over timescales pertinent to forensic investigations. This study therefore aimed to determine if: (1) valve morphology (size and shape) influences diatom persistence, (2) the relative abundance of taxa within an assemblage affects retention, and (3) a persistent diatom assemblage retrieved from clothing after one month can reliably be compared to the site of initial transfer. To build on previous research findings which highlighted the impact of substrate and environmental seasonality on diatom transfer and persistence, here, nine clothing materials were tested in spring before a seasonal comparison in the winter. Fabric swatches were immersed in a freshwater river, worn attached to clothing, and subsamples retrieved at regular intervals (hours, days, weeks) up to one month post-immersion. Diatoms were extracted using a H2O2 technique and analysed via microscopy. The results indicated that smaller diatoms (< 10 µm) are retained in significantly greater abundance, with no statistically significant difference between centric and pennate diatom loss over time. Although a persistent species assemblage was relatively stable over the one month of wear, significant differences were identified between clothing substrate in the spring and between the seasonal samples. The most abundant environmental taxa were consistently identified in the forensic samples, with greater variability attributed to the retention of relatively less common species. The findings suggest that, despite a loss in the abundance and species-richness of diatoms retrieved from clothing over time, a persistent assemblage may provide a useful circumstantial link to the site of initial transfer. The complex relationships between clothing type, environmental seasonality, and time since wear on retention, emphasise the need for diatom trace evidence to be carefully interpreted within an exclusionary framework, and the significance of any casework findings to be determined with reference to empirical evidence bases.

2.
Forensic Sci Int ; 325: 110898, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34247142

RESUMO

Freshwater diatoms offer valuable circumstantial forensic indicators, with a growing empirical research base aiming to identify and understand some of the spatial and temporal factors affecting their validity as trace evidence. Previous studies demonstrated that recipient surface characteristics, environmental variability, and individual species traits influence the initial transfer of freshwater diatoms to clothing. However, no previous research has sought to consider the impact of these and other variables on the persistence of transferred diatoms over investigative timescales. Therefore, this study aimed to identify and explore diatom retention dynamics on clothing following wear over time (hours to weeks). A series of experiments were designed to examine the impact of clothing material, seasonality, and time since wear (persistence interval) on the total number and species-richness of diatoms recovered and their relative retention (%) over time. Nine clothing swatches were immersed in a freshwater environment and then worn for one month in the spring. Subsamples were retrieved at regular intervals (e.g. 30 mins, 1 h, 8 h, 24 h) up to one month, diatoms were extracted using a H2O2 method, and examined microscopically. Three clothing materials were subject to the same experiment in the winter to generate a seasonal comparison. The results broadly identified three stages of diatom persistence on clothing - rapid initial loss, variable intermediate decay, and sustained long-term presence. Clothing material significantly impacted the number of diatoms recovered and retention dynamics over time, with complex interactions identified with seasonality. Although fewer diatoms were recovered in the winter, overall retention trends were consistent at the different times of year. The findings demonstrate that diatoms can be recovered from clothing, even weeks or months after an initial transfer, yielding a useful environmental trace indicator for forensic reconstructions over investigative timescales. The impact of clothing material and seasonality on persistence identified cotton, acrylic, and viscose clothing as the most reliable temporal repository of diatom trace evidence, with a more abundant forensic assemblage available for forensic comparisons in the spring.


Assuntos
Vestuário , Diatomáceas , Água Doce , Ciências Forenses , Humanos , Estações do Ano , Manejo de Espécimes
3.
Forensic Sci Int Genet ; 50: 102393, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33157385

RESUMO

Massively parallel sequencing (MPS) has revolutionised the field of genomics enabling substantial advances in human DNA profiling. Further, the advent of MPS now allows biological signatures to be obtained from complex DNA mixtures and trace amounts of low biomass samples. Environmental samples serve as ideal forms of contact trace evidence as detection at a scene can establish a link between a suspect, location and victim. Many studies have applied MPS technology to characterise the biodiversity within high biomass environmental samples (such as soil and water) to address questions related to ecology, conservation, climate change and human health. However, translation of these tools to forensic science remains in its infancy, due in part to the merging of traditional forensic ecology practices with unfamiliar DNA technologies and complex datasets. In addition, people and objects also carry low biomass environmental signals which have recently been shown to reflect a specific individual or location. The sensitivity, and reducing cost, of MPS is now unlocking the power of both high and low biomass environmental DNA (eDNA) samples as useful sources of genetic information in forensic science. This paper discusses the potential of eDNA to forensic science by reviewing the most explored applications that are leading the integration of this technology into the field. We introduce novel areas of forensic ecology that could also benefit from these tools with a focus on linking a suspect to a scene or establishing provenance of an unknown sample and discuss the current limitations and validation recommendations to achieve translation of eDNA into casework.


Assuntos
Ciências Forenses/métodos , Sequenciamento de Nucleotídeos em Larga Escala , Microbiologia do Solo , Solo/química , DNA/análise , Código de Barras de DNA Taxonômico , Impressões Digitais de DNA , DNA Bacteriano/genética , DNA Fúngico/genética , DNA de Plantas/genética , Diatomáceas/genética , Meio Ambiente , Humanos , Microbiota/genética , Pólen/genética , RNA Ribossômico 16S , Pele/microbiologia
4.
J Dairy Sci ; 103(6): 5422-5430, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32331879

RESUMO

Hoof trimming is used to prevent and treat lameness in dairy cows; however, hoof trimming itself increases daily time spent lying down, possibly due to discomfort. We hypothesized that treatment of lame and nonlame cows with an anti-inflammatory analgesic drug at the time of hoof trimming would mitigate discomfort, thereby improving locomotion scores and reducing post-trimming increases in lying time. We further hypothesized that drug treatment would improve post-trimming milk production. Our objective was to determine the effects of treatment with the nonsteroidal anti-inflammatory drug flunixin meglumine (2.2 mg/kg of BW) at the time of hoof trimming on locomotion, lying times, and milk production in lame and nonlame lactating dairy cows. All cows were filmed for locomotion scoring 1 d before and 1, 8, and 28 d after hoof trimming. Daily time spent standing and lying was recorded for 4 d before and 4 wk after hoof trimming, and daily milk production was recorded for 1 wk before and 8 wk after trimming. Thirty minutes before hoof trimming, an intravenous injection of flunixin meglumine (n = 34) or isotonic sterile saline solution (n = 34) was administered to each cow. Then, all cows had their hooves trimmed using the Dutch method. The same treatment was repeated 24 h after hoof trimming. Cows were categorized using baseline locomotion scores as lame (score ≥3/5) or nonlame (score <3/5). Drug treatment did not affect post-trimming changes in locomotion scores, daily lying times, or milk production. In both treatment groups, most cows had the same lameness status (lame or nonlame) at baseline and after treatment, and there was no difference between groups in the number of cows that changed lameness status over time. Lame cows (n = 21) had no significant changes in lying times over the course of the study, whereas nonlame cows (n = 47) had mean daily lying times that were significantly higher than baseline all 4 wk after trimming. Hoof trimming in nonlame cows should be scheduled for a time when increased lying behavior after trimming can be accommodated.


Assuntos
Anti-Inflamatórios não Esteroides , Doenças dos Bovinos , Clonixina , Casco e Garras , Lactação , Coxeadura Animal , Leite , Animais , Bovinos , Feminino , Anti-Inflamatórios não Esteroides/uso terapêutico , Comportamento Animal/efeitos dos fármacos , Doenças dos Bovinos/tratamento farmacológico , Doenças dos Bovinos/terapia , Clonixina/análogos & derivados , Clonixina/farmacologia , Lactação/efeitos dos fármacos , Coxeadura Animal/tratamento farmacológico , Projetos de Pesquisa
5.
Colorectal Dis ; 22(9): 1139-1146, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32180326

RESUMO

AIM: Our aim was to identify whether personality traits and decision-making styles affect quality of life (QoL) outcomes and levels of psychological distress following pelvic exenteration (PE). METHOD: Patients undergoing PE between 2008 and 2015 were identified from a prospectively maintained database at a single quaternary referral centre. Patients were invited to complete two validated questionnaires, with the Big Five inventory being used to assess personality traits and the Melbourne Decision Making Questionnaire to determine decision-making style. Data on QoL outcomes and distress from the prospectively established database were utilized. QoL with respect to both physical and mental health components was measured using Short Form 36 version 2 (SF-36v2) and the Functional Assessment of Cancer Therapy - Colorectal (FACT-C). Distress was measured using the Distress Thermometer. Postoperative pain scores were also measured using SF-36v2. RESULTS: Of the 93 patients eligible for participation, 42 returned the study questionnaire. On multivariate analysis, neuroticism was the most significant predictor of poorer QoL and increased levels of distress, consistent across all of the measures utilized and at the different time points used. Other personality traits showed an isolated statistically significant impact upon QoL. There were no significant findings with respect to decision-making style. Apart from neuroticism, the most significant predictor of QoL was the number of major complications for the patient. CONCLUSION: Patients demonstrating neurotic personality traits show poorer QoL outcomes and higher levels of distress following PE. Identification of these patients would allow targeted pre- and postoperative intervention to improve outcomes following PE.


Assuntos
Exenteração Pélvica , Qualidade de Vida , Humanos , Personalidade , Período Pós-Operatório , Inquéritos e Questionários
6.
Br J Surg ; 106(10): 1393-1403, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31282571

RESUMO

BACKGROUND: Pelvic exenteration (PE) provides a potentially curative option for advanced or recurrent malignancy confined to the pelvis. A clear (R0) resection margin is the strongest prognostic factor predicting long-term survival, driving most technical advances in PE surgery. The aim of this cohort study was to describe changing trends in extent of resection, postoperative complications, mortality and overall survival after PE surgery. METHODS: Consecutive patients who underwent PE for advanced or recurrent pelvic malignancy at a single institution in Sydney, Australia, were identified. The cohort was divided into three groups based on time periods reflecting annual surgical volume: 1994-2006 (20 or fewer procedures per year), 2007-2013 (21-50 procedures per year) and 2014-2017 (over 50 procedures per year). Primary outcomes were extent of resection, postoperative complications, 60-day mortality and 3-year overall survival. Secondary outcomes were patient characteristics, receipt of neoadjuvant therapy and duration of hospital stay. RESULTS: There were increases over time in rates of lateral and posterior compartment resections (P < 0·001), and bony pelvis (P = 0·002) and neurovascular (P < 0·001) excision. For patients undergoing reconstruction, the proportion receiving vertical rectus abdominus myocutaneous flaps increased significantly (P = 0·005). Rates of wound infection, dehiscence, and abdominal and pelvic collections increased over the study interval. Short-term mortality decreased, and 1- and 3-year survival rates improved. CONCLUSION: Technical and surgical advancements have led to more complex PE resections, with R0 and mortality rates improving with higher annual volume. There were associated increases in intraoperative blood loss and postoperative morbidity.


ANTECEDENTES: La exenteración pélvica (pelvic exenteration, PE) ofrece una opción potencialmente curativa para el cáncer localmente avanzado o la recidiva de la neoplasia limitada a la pelvis. Un margen de resección libre (R0) es el factor pronóstico más importante que predice la supervivencia a largo plazo, lo que ha impulsado la mayoría de los avances técnicos en la cirugía de la PE. El objetivo de este estudio de cohortes fue describir el cambio en la tendencia relativa a la extensión de la resección, las complicaciones postoperatorias, la mortalidad y la supervivencia global después de la cirugía de la PE. MÉTODOS: Se identificaron pacientes intervenidos de forma consecutiva a los que se practicó una PE por neoplasia pélvica avanzada o recidivante en una sola institución en Sydney, Australia. La cohorte se dividió en tres grupos según períodos de tiempo que reflejan el volumen quirúrgico anual: 1994-2006 (≤ 20 casos por año), 2007-2013 (21-50 casos por año) y 2014-2017 (> 50 casos por año). Los criterios de valoración principal fueron la extensión de la resección, las complicaciones postoperatorias, la mortalidad a los 60 días y la supervivencia a los tres años. Los criterios de valoración secundarios fueron las características del paciente, la administración de tratamiento neoadyuvante y la duración de la estancia hospitalaria. Las tendencias se evaluaron mediante pruebas de χ2 o ANOVA de una vía. RESULTADOS: Los porcentajes de resección de los compartimentos lateral y posterior, pelvis ósea así como de escisión neurovascular aumentaron con el tiempo (P < 0,01). Entre los pacientes en los que se hizo una reconstrucción, el porcentaje de colgajos miocutáneos verticales del recto del abdomen aumentó significativamente (P = 0,005). Las tasas de infección de herida, dehiscencia y colecciones abdominales y pélvicas aumentaron durante el período de estudio. La mortalidad a corto plazo disminuyó y la supervivencia a 1 y 3 años mejoró durante el período de estudio. CONCLUSIÓN: Los avances técnicos y quirúrgicos han permitido realizar resecciones de PE más complejas, mejorando las tasas de resección R0 y de mortalidad al aumentar el volumen anual de intervenciones. Al mismo tiempo se han observado incrementos en las pérdidas intraoperatorias de sangre, en las reconstrucciones y en la morbilidad postoperatoria.


Assuntos
Exenteração Pélvica/métodos , Neoplasias Pélvicas/cirurgia , Análise de Variância , Perda Sanguínea Cirúrgica/estatística & dados numéricos , Cuidados Críticos/estatística & dados numéricos , Feminino , Humanos , Estimativa de Kaplan-Meier , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/cirurgia , Duração da Cirurgia , Readmissão do Paciente/estatística & dados numéricos , Exenteração Pélvica/mortalidade , Neoplasias Pélvicas/mortalidade , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/mortalidade , Estudos Retrospectivos , Resultado do Tratamento
7.
BJS Open ; 2(5): 328-335, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30263984

RESUMO

BACKGROUND: Pelvic exenteration (PE) is the preferred treatment available for selected patients diagnosed with locally advanced or recurrent cancer confined to the pelvis. Currently, the majority of the literature reports only on short-term survival and quality-of-life (QoL) outcomes. The aim of this prospective cohort study was to describe long-term survival and QoL outcomes following PE. METHODS: This was a cohort study of consecutive patients undergoing PE from 1994 to 2016 at a major teaching hospital in Sydney, Australia. From 2008, consenting patients were also included in a prospective QoL study. Main outcomes were long-term survival and QoL assessed with SF-36® and FACT-C questionnaires. Survival was estimated using the Kaplan-Meier method. RESULTS: Some 515 patients underwent PE for locally advanced or recurrent cancer. The cumulative 5- and 10-year overall survival rates were 48·6 and 37·8 per cent respectively. The survival estimates were significantly higher for patients with advanced primary rectal cancer (P = 0·045) and those in whom a clear resection margin was achieved (P < 0·001). Some 287 patients were enrolled into the QoL study. Response rates at baseline, 6 months and 5 years were 92·0, 70·0 and 33 per cent respectively. Patients had recovered to their preoperative QoL status by 6 months and, among survivors, QoL remained essentially unchanged during the 5-year follow-up. CONCLUSION: Patients who underwent PE owing to advanced primary rectal cancer or achieved a clear resection margin had a greater chance of survival. Overall, QoL returned to baseline within 6 months after surgery.

8.
Neuroradiology ; 60(10): 1063-1073, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30105622

RESUMO

PURPOSE: Brain metabolites show very rapid maturation over infancy, particularly following very preterm (VPT) birth, and can provide an index of brain injury. The utility of magnetic resonance imaging (MRS, magnetic resonance spectroscopy) in predicting outcome in VPT-born infants is largely limited to 2-year outcomes. We examined the value of MRS in VPT followed longitudinally to 4 years. METHODS: MRS datasets were acquired in 45 VPT infants (< 32 weeks gestational age) longitudinally: at birth, at term-equivalent and at 4 years of age. Using LCModel analyses in a basal ganglia voxel, we investigated metabolite ratios as a function of age, brain injury and outcome. We also studied a full-term (FT) cohort at 4 years and compared group differences with outcome. RESULTS: We found significant age-related changes in many brain metabolites in infancy, including phosphocreatine (CR)/phosphocholine (CHO), N-acetylaspartylglutamate (NAA)/CHO, myoinositol (INS)/CHO and INS/CR; there were no significant MRS differences between VPT and FT groups at 4 years of age, or differences at 4 years as a function of early brain injury or outcome. The rate of change in metabolite ratios from VPT birth to term-equivalent age did not predict outcome in the VPT children at 4 years. CONCLUSION: Brain metabolite ratios measured in VPT-born infants have shown associations with short-term outcomes, but these correlations did not extend to early childhood nor predict cognitive sequelae. The most frequently reported poor outcome in VPT-born children is cognitive difficulties starting at early school age. MRS metrics early in the infant's life do not appear to predict these longer-term outcomes.


Assuntos
Encéfalo/metabolismo , Lactente Extremamente Prematuro , Espectroscopia de Ressonância Magnética/métodos , Ácido Aspártico/análogos & derivados , Ácido Aspártico/metabolismo , Pré-Escolar , Colina/metabolismo , Creatina/metabolismo , Feminino , Humanos , Recém-Nascido , Inositol/metabolismo , Estudos Longitudinais , Masculino
9.
Meat Sci ; 143: 18-23, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29684840

RESUMO

The objective of this study was to investigate the ability of computer vision system to predict pork intramuscular fat percentage (IMF%). Center-cut loin samples (n = 85) were trimmed of subcutaneous fat and connective tissue. Images were acquired and pixels were segregated to estimate image IMF% and 18 image color features for each image. Subjective IMF% was determined by a trained grader. Ether extract IMF% was calculated using ether extract method. Image color features and image IMF% were used as predictors for stepwise regression and support vector machine models. Results showed that subjective IMF% had a correlation of 0.81 with ether extract IMF% while the image IMF% had a 0.66 correlation with ether extract IMF%. Accuracy rates for regression models were 0.63 for stepwise and 0.75 for support vector machine. Although subjective IMF% has shown to have better prediction, results from computer vision system demonstrates the potential of being used as a tool in predicting pork IMF% in the future.


Assuntos
Gorduras na Dieta/análise , Inspeção de Alimentos/métodos , Qualidade dos Alimentos , Carne/análise , Modelos Biológicos , Músculo Esquelético/química , Algoritmos , Animais , Inteligência Artificial , Comportamento do Consumidor , Análise Discriminante , Inspeção de Alimentos/instrumentação , Preferências Alimentares , Humanos , Aprendizado de Máquina , Pigmentos Biológicos/análise , Análise de Regressão , Reprodutibilidade dos Testes , Estatística como Assunto , Máquina de Vetores de Suporte , Sus scrofa
10.
J Anim Sci ; 96(4): 1221-1236, 2018 Apr 14.
Artigo em Inglês | MEDLINE | ID: mdl-29669076

RESUMO

Residual feed intake (RFI) is the difference between observed and predicted feed intake of an animal, based on growth and maintenance requirements. In Yorkshire pigs, divergent selection for increased (Low RFI) and decreased (High RFI) RFI was carried out over 10 generations (G) while feeding a corn- and soybean-meal-based, higher-energy, lower-fiber (HELF) diet. In G8 to G10, representing 4 replicates, barrows and gilts (n = 649) of the RFI lines were fed the HELF diet and a diet incorporating coproducts that were lower in energy and higher in dietary fiber (LEHF). The diets differed in ME, 3.32 vs. 2.87 Mcal/kg, and in neutral detergent fiber (NDF), 9.4% vs. 25.9%, respectively. The impact of the LEHF diet on 1) performance and growth, 2) diet digestibility, 3) genetic parameter estimates, and 4) responses to selection for RFI, when fed the HELF, was assessed. In general, the LEHF diet reduced the performance of both lines. When fed the HELF diet, the Low RFI pigs had lower (P < 0.05) ADFI (-12%), energy intake (-12%), ADG (-6%), and backfat depth (-12%); similar (P > 0.05) loin muscle area (LMA; +5%); and greater (P < 0.05) feed efficiency (i.e., 8% higher G:F and 7% lower RFI) than the High RFI line. These patterns of line differences were still present under the LEHF diet but differences for ADFI (-11%), energy intake (-10%), G:F (+2%), and RFI (-6%) were reduced compared to the HELF diet. Apparent total tract digestibility (ATTD) of the HELF and LEHF diets was assessed using 116 barrows and gilts from G8. When fed the HELF diet, ATTD of DM, GE, N, and NDF were similar between lines (P ≥ 0.27), but when fed the LEHF diet, the Low RFI pigs had greater digestibility (7%, 7%, 10%, and 32%) than the High RFI line (P ≤ 0.04). To measure responses to selection for RFI and estimate genetic parameters, data from all 10 generations were used (HELF; n = 2,310; LEHF, n = 317). Heritability estimates of performance traits ranged from 0.19 to 0.63, and genetic correlations of traits between diets were high and positive, ranging from 0.87 (RFI) to 0.99 (LMA). By G10, RFI in the Low RFI line was 3.86 and 1.50 genetic SD lower than in the High RFI line when fed the HELF and LEHF diets, respectively. Taken together, the results of this study demonstrate that responses to selection for RFI when fed a HELF diet are not fully realized when pigs are fed an extremely LEHF diet. Thus, feeding diets that differ from those used for selection may not maximize genetic potential for feed efficiency.


Assuntos
Ração Animal/análise , Fibras na Dieta/administração & dosagem , Ingestão de Energia , Suínos/fisiologia , Animais , Dieta/veterinária , Digestão/fisiologia , Feminino , Trato Gastrointestinal/fisiologia , Fenótipo , Zea mays
11.
Eur J Cancer Care (Engl) ; 27(2): e12588, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27734541

RESUMO

Lung cancer is a significant international health problem. Aligning clinical practice with evidence-based guideline recommendations has the potential to improve patient outcomes. This scoping review describes evidence-practice gaps across the diagnostic and management care pathway for lung cancer. We conducted searches of online databases Medline, PsychInfo, Cinahl and the Cochrane Library to identify studies published between 2008 and 2012. Of 614 articles screened, 65 met inclusion criteria. We identified seven evidence-practice gaps: (1) delays in timely diagnosis and referral; (2) curative and (3) palliative treatments are under-utilised; (4) older age and co-morbidities influence the use of treatments; (5) the benefits of multidisciplinary team review are not available to all lung cancer patients; (6) psychosocial needs are unmet; and (7) early referral to palliative care services is under-utilised. The scoping review highlighted three key messages: (1) there are significant challenges in the timely diagnosis and referral of lung cancer; (2) curative and palliative treatments, psychosocial support and palliative care are under-utilised in lung cancer management; and (3) variations in treatment utilisation appear to be associated with non-disease factors such as patient characteristics, provider practices and the organisation of health care services. Future research should focus on designing interventions to overcome variations in care.


Assuntos
Neoplasias Pulmonares , Oncologia , Lacunas da Prática Profissional , Medicina Baseada em Evidências , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/terapia , Cuidados Paliativos , Psico-Oncologia/normas , Encaminhamento e Consulta/normas
12.
Colorectal Dis ; 20(5): 438-448, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29053219

RESUMO

AIM: The aim was to compare the effectiveness of chewing sugar-free gum after bowel resection on bowel function and length of stay. METHOD: This was a randomized controlled trial of patients undergoing elective open or laparoscopic bowel surgery, who were allocated into two groups: a chewing gum group (CG); or a nonchewing gum group (NG). Primary outcomes were time to discharge (length of hospital stay [LOS]), time to first flatus (TFF) and time to first bowel motion (TBM). Secondary outcomes were complication rates, pain and total morphine equivalent (TMEq) medication for 7 days after the procedure. RESULTS: Between 2010 and 2013, 162 patients were randomized; four were excluded, leaving 158 in the study (82 in the CG and 76 in the NG). There was no difference in LOS between the CG (5.8 days) and the NG (6.1 days) (P = 0.403) or in the median TFF between the CG (42.0 h) and the NG (58.0 h) (P = 0.076). The median TBM was lower in the CG (40.0 h) than in the NG (90.0 h) (P = 0.002). There was no difference in intra-operative complications between the CG (9%) and the NG (9%) (P = 0.901) or in early postoperative complications (44% for CG and 55% for NG) (P = 0.131). There was no difference in TMEq at 24 h postprocedure, but the CG had reduced TMEq from days 2 to 7 post procedure and for the 7-day total. Pain was higher among patients in the NG on day 3. CONCLUSION: Chewing sugar-free gum resulted in an earlier return to bowel function and decreased analgesic requirements. There was no decrease in overall LOS or postoperative complications.


Assuntos
Goma de Mascar , Colectomia/métodos , Laparoscopia/métodos , Dor Pós-Operatória/tratamento farmacológico , Complicações Pós-Operatórias/prevenção & controle , Adulto , Idoso , Analgésicos/uso terapêutico , Defecação , Procedimentos Cirúrgicos Eletivos , Feminino , Flatulência , Motilidade Gastrointestinal , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Estudos Prospectivos , Recuperação de Função Fisiológica , Fatores de Tempo , Resultado do Tratamento
13.
Colorectal Dis ; 20(4): 312-320, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29053230

RESUMO

AIM: Biofeedback is an established, effective and non-invasive treatment for faecal incontinence (FI). The aim was to compare the effectiveness of four different biofeedback treatment regimes. METHOD: This was a randomized control trial of patients with FI, stratified into two groups (metropolitan and rural) and then randomized into two subgroups (groups 1 and 2 within metropolitan, groups 3 and 4 within rural) with varying face-to-face and telephone biofeedback components. All patients received standardized counselling and education, dietary modification and the use of anti-diarrhoeal medications. Group 1 received four monthly face-to-face biofeedback treatments, groups 2 and 3 received one face-to-face biofeedback followed by telephone biofeedback and group 4 received a one-off face-to-face biofeedback treatment. Primary outcomes were patient-assessed severity of FI and quality of life as assessed by the 36-item Short Form Health Survey and direct questioning of objectives. Secondary outcomes included St Mark's incontinence score, anxiety, depression and anorectal physiology measures (resting, squeeze pressures; isotonic, isometric fatigue times). RESULTS: Between 2006 and 2012, 351 patients were recruited. One patient died leaving 350 for analysis. 332 (95%) were women. Mean age was 60 (SD = 14). All groups had significant improvements in FI, quality of life, incontinence score and mental status (P < 0.001 each). There were no differences in improvements in FI between groups although patient satisfaction was less with reduced face-to-face contact. There were modest improvements in isotonic and isometric fatigue times suggesting improved sphincter endurance (both P < 0.001). CONCLUSION: Biofeedback is effective for FI. Although face-to-face and telephone biofeedback is not necessary to improve FI, it is important for patient satisfaction.


Assuntos
Biorretroalimentação Psicológica/métodos , Incontinência Fecal/psicologia , Incontinência Fecal/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Estudos Prospectivos , Qualidade de Vida , Telefone , Resultado do Tratamento
14.
J Dairy Sci ; 100(8): 6562-6566, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28624288

RESUMO

The objective of this study was to evaluate the effect of flunixin meglumine treatment on lameness pain in dairy cows. Twenty-four lactating Holstein cows were enrolled in the study based on visual observation of abnormal locomotion. The primary measurement endpoint was weight-shifting between the rear limbs. Weight-shifting was calculated as the standard deviation of the weight borne on the rear limbs over a 15 min period; this value correlates directly with lameness pain in dairy cows. After collecting baseline weight-bearing data, we randomly assigned cows to 1 of 2 treatment groups: 2.2 mg/kg body weight flunixin meglumine (2 mL/45 kg) or an equivalent volume of isotonic sterile saline solution. Weight-bearing data were collected from each cow at 2, 6, 12, and 24 h after a single intravenous drug treatment. Mean locomotion scores over the 2 d before treatment were 2.38/5 in the flunixin-treated group and 2.43/5 in the saline-treated control group; these values were not significantly different. Weight-shifting values were also not significantly different on either pretreatment day. Cows treated with flunixin meglumine showed significantly less weight-shifting between the rear limbs at 6, 12, and 24 h after treatment compared with saline-treated controls, providing evidence that flunixin meglumine alleviates lameness-associated pain.


Assuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Bovinos/fisiologia , Clonixina/análogos & derivados , Indústria de Laticínios/métodos , Coxeadura Animal/tratamento farmacológico , Animais , Clonixina/uso terapêutico , Feminino , Marcha , Lactação , Dor/tratamento farmacológico , Dor/veterinária , Suporte de Carga/fisiologia
15.
FEMS Microbiol Ecol ; 93(2)2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-27979996

RESUMO

Analysis of physical evidence is typically a deciding factor in forensic casework by establishing what transpired at a scene or who was involved. Forensic geoscience is an emerging multi-disciplinary science that can offer significant benefits to forensic investigations. Soil is a powerful, nearly 'ideal' contact trace evidence, as it is highly individualistic, easy to characterise, has a high transfer and retention probability, and is often overlooked in attempts to conceal evidence. However, many real-life cases encounter close proximity soil samples or soils with low inorganic content, which cannot be easily discriminated based on current physical and chemical analysis techniques. The capability to improve forensic soil discrimination, and identify key indicator taxa from soil using the organic fraction is currently lacking. The development of new DNA sequencing technologies offers the ability to generate detailed genetic profiles from soils and enhance current forensic soil analyses. Here, we discuss the use of DNA metabarcoding combined with high-throughput sequencing (HTS) technology to distinguish between soils from different locations in a forensic context. Specifically, we provide recommendations for best practice, outline the potential limitations encountered in a forensic context and describe the future directions required to integrate soil DNA analysis into casework.


Assuntos
Código de Barras de DNA Taxonômico , Microbiologia do Solo , DNA , Impressões Digitais de DNA , Análise de Sequência de DNA , Solo/química
16.
J Anim Sci ; 94(10): 4120-4132, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27898858

RESUMO

As feed costs continue to rise and efficiency during finishing is emphasized, the impact of selecting for more efficient grow/finish pigs on reproductive performance and feed efficiency of sows must be evaluated. Therefore, the objectives of this study were to evaluate correlated responses for sow reproductive performance and lactation feed efficiency to selection for residual feed intake (RFI) during the grow/finish phase of production (RFI) in 2 selection lines of pigs developed at Iowa State University (Ames, IA) and to estimate heritabilities of these traits. One line was selected over 7 generations for decreased RFIG/F (low RFI [LRFI] line) and the other line was randomly selected for 5 generations and then selected for increased RFIG/F (high RFI [HRFI] line). After 7 generations of selection, LRFI sows had 1.0 more piglets farrowed ( = 0.11) compared with HRFI sows, 1.3 more pigs born alive ( < 0.05), similar farrowing survival, 0.4 fewer mummies ( < 0.01), and more piglets weaned, both by litter (1.6 more; < 0.01) and by sow (1.1 more; < 0.01). Low RFI sows consumed 25 kg less feed and lost 9.8 kg more BW, 7.0 kg more fat mass, and 3.1 mm more backfat than HRFI sows ( < 0.001) during lactation. Although LRFI sows had a greater negative energy balance (-19.8 vs. -8.0 MJ ME/d; < 0.001), they had better RFI during lactation (-28.6 vs. 8.2 kg; < 0.0001), and the trend was for LRFI sows to have better lactation efficiency (61.3 vs. 57.8%; = 0.47) than HRFI sows. Heritabilities for sow weights, sow body composition, sow maintenance requirements (estimated from BW), and piglet birth weight were high ( > 0.4, SE < 0.07). Traits pertaining to piglet growth during lactation and mobilization of body tissue of the sow were moderately heritable (0.2 < < 0.4, SE < 0.07). In conclusion, selection for decreased RFI has favorably affected piglet performance and lactation efficiency but has unfavorably affected sow body condition loss and energy balance during lactation. These results indicate that pigs selected for increased efficiency during grow-finish are better able to direct resources where needed during other life history phases, that is, reproduction and lactation.


Assuntos
Sus scrofa/fisiologia , Animais , Peso ao Nascer , Composição Corporal , Metabolismo Energético , Feminino , Iowa , Lactação , Masculino , Reprodução , Sus scrofa/crescimento & desenvolvimento , Suínos , Desmame
17.
J Chem Phys ; 145(15): 154111, 2016 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-27782462

RESUMO

Direct coexistence molecular dynamics simulations of NaCl solutions and Lennard-Jones binary mixtures were performed to explore the origin of reported discrepancies between solubilities obtained by direct interfacial simulations and values obtained from the chemical potentials of the crystal and solution phases. We find that the key cause of these discrepancies is the use of crystal slabs of insufficient width to eliminate finite-size effects. We observe that for NaCl crystal slabs thicker than 4 nm (in the direction perpendicular to the interface), the same solubility values are obtained from the direct coexistence and chemical potential routes, namely, 3.7 ± 0.2 molal at T = 298.15 K and p = 1 bar for the JC-SPC/E model. Such finite-size effects are absent in the Lennard-Jones system and are likely caused by surface dipoles present in the salt crystals. We confirmed that µs-long molecular dynamics runs are required to obtain reliable solubility values from direct coexistence calculations, provided that the initial solution conditions are near the equilibrium solubility values; even longer runs are needed for equilibration of significantly different concentrations. We do not observe any effects of the exposed crystal face on the solubility values or equilibration times. For both the NaCl and Lennard-Jones systems, the use of a spherical crystallite embedded in the solution leads to significantly higher apparent solubility values relative to the flat-interface direct coexistence calculations and the chemical potential values. Our results have broad implications for the determination of solubilities of molecular models of ionic systems.

18.
Br J Surg ; 103(11): 1548-56, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27559684

RESUMO

BACKGROUND: The rising cost of healthcare is well documented. The purpose of this study was to determine the cost-effectiveness of pelvic exenteration (PE). METHODS: Consecutive patients referred for consideration of PE between 2008 and 2011 were recruited into a prospective non-randomized study that compared quality of life (QoL) between patients who did or did not undergo PE. Information on QoL and cost (in Australian dollars, AUD) was collected at baseline, during admission and up to 24 months after discharge. QoL data were converted into a utility-based measure. Quality-adjusted life-years (QALYs) were calculated. Bottom-up costing was performed. The incremental cost-effectiveness ratio (ICER) was calculated per life-year saved and per QALY. RESULTS: There were 174 patients with sufficient data for analysis. Of these, 139 underwent PE. R0 was achieved in 78·4 per cent of patients. The survival rate at 24 months after PE was 74·8 per cent compared with 43 per cent in those without exenteration (P = 0·001). Treatment costs were significantly higher for patients who had PE compared with those who did not (mean AUD 137 407 versus 79 174; P < 0·001). The ICER was AUD 124 147 (95 per cent c.i. 71 585 to 261 876) per life-year saved and AUD 227 330 (109 974 to 1 100 449) per QALY. Curative PE (R0) was found to be more cost-effective than non-curative PE (R1/R2), with an ICER of AUD 101 518 (60 105 to 200 428) versus 390 712 (74 368 to 82 256 739) per life-year saved. CONCLUSION: Treatment of advanced pelvic cancers is expensive regardless of the treatment intent. For a cost difference of only AUD 58 000 (€38 264), PE offers a chance of cure, and improves survival and QoL.


Assuntos
Exenteração Pélvica/economia , Neoplasias Pélvicas/cirurgia , Análise Custo-Benefício , Humanos , New South Wales , Ensaios Clínicos Controlados não Aleatórios como Assunto , Estudos Prospectivos , Qualidade de Vida , Anos de Vida Ajustados por Qualidade de Vida , Vitória
19.
J Anim Sci ; 94(6): 2317-31, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27285909

RESUMO

Lactation is an economically and biologically important phase in the life cycle of sows. Short generation intervals in nucleus herds and low heritability of traits associated with lactation along with challenges associated with collecting accurate lactation performance phenotypes emphasize the importance of using genomic tools to examine the underlying genetics of these traits. We report the first genomewide association study (GWAS) on traits associated with lactation and efficiency in 2 lines of Yorkshire pigs that were divergently selected for residual feed intake during grow-finish phase. A total of 862 farrowing records from 2 parities were analyzed using a Bayesian whole genome variable selection model (Bayes B) to locate 1-Mb regions that were most strongly associated with each trait. The GWAS was conducted separately for parity 1 and 2 records. Marker-based heritabilities ranged from 0.03 to 0.39 for parity 1 traits and from 0.06 to 0.40 for parity 2 traits. For all traits studied, around 90% of genetic variance came from a large number of genomic regions with small effects, whereas genomic regions with large effects were found to be different for the same trait measured in parity 1 and 2. The highest percentage of genetic variance explained by a 1-Mb window for each trait ranged from 0.4% for feed intake during lactation to 4.2% for back fat measured at farrowing in parity 1 sows and from 0.2% for lactation feed intake to 5.4% for protein mass loss during lactation in parity 2 sows. A total of thirteen 1-Mb nonoverlapping windows were found to explain more than 1.5% of genetic variance for either a single trait or across multiple traits. These 1-Mb windows were on chromosomes 2, 3, 6, 7, 8, 11, 14, 15, 17, and 18. The major positional candidate genes within 1 Mb upstream and downstream of these windows were , (SSC2), (SSC6) (SSC7), (SSC8), (SSC11), (SSC14), (SSC17). Further validation studies on larger populations are required to validate these findings and to improve our understanding of the biology and complex genetic architecture of traits associated with sow lactation performance.


Assuntos
Ingestão de Alimentos/genética , Estudo de Associação Genômica Ampla , Lactação/genética , Suínos/genética , Ração Animal , Animais , Teorema de Bayes , Cruzamento , Feminino , Lactação/fisiologia , Paridade , Fenótipo , Gravidez , Seleção Genética , Suínos/crescimento & desenvolvimento , Suínos/fisiologia , Aumento de Peso/genética
20.
Eur J Surg Oncol ; 42(6): 823-8, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26947962

RESUMO

INTRODUCTION: Radical surgery with pelvic exenteration offers the only potential for cure in patients with locally advanced primary rectal cancer. This study describes the clinical and patient-reported quality of life outcomes over 12 months for patients having pelvic exenteration for locally advanced primary rectal cancer at a specialised centre for pelvic exenteration. METHODS: Clinical data of consecutive patients undergoing pelvic exenteration for locally advanced primary rectal cancer and patient-reported outcomes were collected at baseline, hospital discharge and at 1, 3, 6, 9 and 12 months. Patient-reported outcomes included cancer-specific quality of life (QoL) and physical and mental health status. Quality of life trajectories were modelled over the 12 months from the date of surgery using linear mixed models. RESULTS: 104 patients with locally advanced rectal cancer underwent pelvic exenteration at Royal Prince Alfred Hospital, Sydney, between December 1994 and October 2014. Complete soft tissue exenteration was performed in 38%. A clear margin was obtained in 86% with a 62% overall five-year survival. QoL outcome questionnaires were completed by 62% of patient cohort. The average FACT-C score returned to pre-surgery QoL by 2 months after surgery, and the average QoL continued to increase slowly over the 12 months. CONCLUSION: Our results support an aggressive approach to advanced primary rectal cancer and lend weight to the oncological role of pelvic exenteration for this group of patients. Quality of life improves rapidly after pelvic exenteration for locally advanced primary rectal cancer and continues to improve over the first year.


Assuntos
Exenteração Pélvica , Qualidade de Vida , Neoplasias Retais/patologia , Neoplasias Retais/cirurgia , Autorrelato , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Estimativa de Kaplan-Meier , Tempo de Internação , Masculino , Pessoa de Meia-Idade , New South Wales , Exenteração Pélvica/efeitos adversos , Exenteração Pélvica/métodos , Exenteração Pélvica/psicologia , Neoplasias Retais/mortalidade , Neoplasias Retais/psicologia , Resultado do Tratamento
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