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1.
Lab Med ; 2021 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-33942859

RESUMO

OBJECTIVE: To explore the experiences of medical laboratory professionals (MLPs) and their perceptions of the needs of clinical laboratories in response to COVID-19. METHODS: We surveyed laboratory professionals working in United States clinical laboratories during the initial months of the pandemic. RESULTS: Overall clinical laboratory testing and overtime work for laboratorians decreased during the first months of the pandemic. Laboratory professionals reported better or unchanged job satisfaction, feelings toward their work, and morale in their workplace, which were related to healthcare facility and laboratory leadership response. They reported receiving in-kind gifts, but no hazard pay, for their essential work. Important supply needs included reagents and personal protective equipment (PPE). CONCLUSION: The response by healthcare facilities and laboratory leadership can influence MLPs job satisfaction, feelings toward their work, and laboratory morale during a pandemic. Current COVID-19 laboratory testing management, in the absence of sufficient reagents and supplies, cannot fully address the needs of clinical laboratories.

2.
Redox Biol ; 43: 101974, 2021 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-33940546

RESUMO

Ingested inorganic nitrate (NO3⁻) has multiple effects in the human body including vasodilation, inhibition of platelet aggregation, and improved skeletal muscle function. The functional effects of oral NO3⁻ involve the in vivo reduction of NO3⁻ to nitrite (NO2⁻) and thence to nitric oxide (NO). However, the potential involvement of S-nitrosothiol (RSNO) formation is unclear. We hypothesised that the RSNO concentration ([RSNO]) in red blood cells (RBCs) and plasma is increased by NO3⁻-rich beetroot juice ingestion. In healthy human volunteers, we tested the effect of dietary supplementation with NO3⁻-rich beetroot juice (BR) or NO3⁻-depleted beetroot juice (placebo; PL) on [RSNO], [NO3⁻] and [NO2⁻] in RBCs, whole blood and plasma, as measured by ozone-based chemiluminescence. The median basal [RSNO] in plasma samples (n = 22) was 10 (5-13) nM (interquartile range in brackets). In comparison, the median values for basal [RSNO] in the corresponding RBC preparations (n = 19) and whole blood samples (n = 19) were higher (p < 0.001) than in plasma, being 40 (30-60) nM and 35 (25-80) nM, respectively. The median RBC [RSNO] in a separate cohort of healthy subjects (n = 5) was increased to 110 (93-125) nM after ingesting BR (12.8 mmol NO3⁻) compared to a corresponding baseline value of 25 (21-31) nM (Mann-Whitney test, p < 0.01). The median plasma [RSNO] in another cohort of healthy subjects (n = 14) was increased almost ten-fold to 104 (58-151) nM after BR supplementation (7 × 6.4 mmol of NO3⁻ over two days, p < 0.01) compared to PL. In conclusion, RBC and plasma [RSNO] are increased by BR ingestion. In addition to NO2⁻, RSNO may be involved in dietary NO3⁻ metabolism/actions.

3.
Br J Health Psychol ; 2021 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-33949052

RESUMO

OBJECTIVES: The primary objective of the study was to examine the effect of calorie labelling and physical activity equivalence labelling of alcoholic drinks on drinking intentions in participants of lower and higher socioeconomic position (SEP). METHODS: Participants (N = 1,084) of higher and lower SEP were recruited into an online study and randomized into one of three drink label conditions; Control (standard alcohol labelling), kcal labelling (standard labelling plus drink kilocalorie information), or kcal + PACE labelling (standard labelling and kilocalorie information, plus information on physical activity needed to compensate for drink calories). After viewing drink labels, participants reported alcohol drinking intentions. Participants also completed measures of alcoholic drink energy content estimation, beliefs about how calorie labelling would affect health behaviour and support for calorie labelling of alcoholic drinks. RESULTS: kcal labelling (d = 0.31) and kcal + PACE labelling (d = 0.38) conditions had significantly lower drinking intentions compared to the control condition (ps < .001). There was no evidence that effect of labelling condition on drinking intentions was moderated by SEP. A subset of participants also reported that they believed calorie labelling would be likely to positively change their eating and exercise behaviour. Estimates of the energy content of alcoholic drinks tended to be inaccurate and the majority of participants supported the introduction of calorie labelling on alcoholic drinks. CONCLUSIONS: Calorie labelling of alcoholic drinks resulted in small reductions to intended drinking and testing of the effect calorie labelling has on behaviour in real-world settings is now warranted.

4.
J Nurs Meas ; 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33795487

RESUMO

BACKGROUND AND PURPOSE: An exploratory latent class analysis (LCA) was performed assessing the association between maternity waiting home (MWH) use and maternal-newborn care knowledge. METHODS: A two-group comparison design using a face-to-face interview (n = 250) was conducted to understand if MWH use was associated with greater maternal knowledge of newborn care. RESULTS: High levels of maternal knowledge of newborn care were associated with MWH use. Mothers with low levels of knowledge were less likely to use an MWH prior to delivery and more likely to have fewer pregnancies, attend less than four antenatal care (ANC) visits, and receive no education about newborn health problems during ANC. CONCLUSIONS: Nurses need to target younger, primigravida mothers attending fewer ANC visits with educational opportunities while advocating for expansion of health education at MWHs to potentiate long-term benefits for improved maternal-newborn health and delivery outcomes.

5.
Health Econ ; 2021 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-33890334

RESUMO

Using monthly data from the Understanding Society (UKHLS) COVID-19 Survey we analyse the evolution of unmet need and assess how the UK health care system performed against the principle of horizontal equity in health care use during the first wave of COVID-19 wave. Unmet need was most evident for hospital care, and less pronounced for primary health services (non-emergency medical helplines, GP consultations, community pharmacist advice, over the counter medications and prescriptions). Despite this, there is no evidence that horizontal equity, with respect to income, was violated for NHS hospital outpatient and inpatient care during the first wave of the pandemic. There is evidence of pro-rich inequities in use of GP consultations, prescriptions and medical helplines at the peak of the first wave, but these were eliminated as the pandemic progressed. There are persistent pro-rich inequities for services that may relate to individuals' ability to pay (over the counter medications and advice from community pharmacists).

6.
Alcohol Alcohol ; 2021 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-33836535

RESUMO

AIMS: Deficits in motor inhibitory control and working memory have been hypothesized to be both a cause and consequence of heavy alcohol use. Adolescence is a critical developmental stage for inhibitory control and working memory, and it is also a stage when individuals are most likely to initiate alcohol use. This study aimed to examine whether inhibitory control and working memory would predict alcohol use and involvement in a group of UK adolescents. METHODS: We recruited 220 (N = 178, female) adolescents, aged between 16 and 18, from eight higher education settings in the Merseyside region of the UK. Alcohol use was examined using the Timeline Follow-Back and involvement (and related problems) using the Adolescent Alcohol Involvement Scale. A reward-based inhibitory control task (Go/No-Go) was used to examine the inhibition and reward sensitivity, and a self-ordered pointing task was used to measure working memory. RESULTS: Multiple regression demonstrated that neither inhibitory control (b = 0.02 (95% confidence interval (CI): -0.21, 0.24)) nor working memory (b = -0.12 (95% CI: -0.30, 0.07)) were significant predictors of alcohol use (units consumed). Inhibitory control (b = 0.61 (95% CI: 0.12, 1.09), specifically, in the no reward condition and school deprivation (b = 0.67 (95% CI: 0.06, 1.28) significantly predicted alcohol-related problems. CONCLUSIONS: Our findings demonstrated limited evidence that deficits in specific mechanisms of executive functioning (i.e. motor inhibition and working memory) were associated with alcohol-related problems in UK adolescents. This study adds to an increasing body of literature suggesting weak or non-existent links between inhibitory control, working memory and alcohol use.

7.
Health Econ ; 2021 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-33904203

RESUMO

We use data from the UK Household Longitudinal Study (UKHLS) to compare measures of socioeconomic inequality in psychological distress, measured by the General Health Questionnaire (GHQ), before (Waves 9 and the Interim 2019 Wave) and during the first wave of the COVID-19 pandemic (April to July 2020). Based on a caseness measure, the prevalence of psychological distress increased from 18.5% to 27.7% between the 2019 Wave and April 2020 with some reversion to earlier levels in subsequent months. Also, there was a systematic increase in total inequality in the Likert GHQ-12 score. However, measures of relative socioeconomic inequality have not increased. A Shapley-Shorrocks decomposition analysis shows that during the peak of the first wave of the pandemic (April 2020) other socioeconomic factors declined in their share of socioeconomic inequality, while age and gender account for a larger share. The most notable increase is evident for younger women. The contribution of working in an industry related to the COVID-19 response played a small role at Wave 9 and the Interim 2019 Wave, but more than tripled its share in April 2020. As the first wave of COVID-19 progressed, the contribution of demographics declined from their peak level in April and chronic health conditions, housing conditions, and neighbourhood characteristics increased their contributions to socioeconomic inequality.

8.
J Hum Nutr Diet ; 2021 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-33899984

RESUMO

BACKGROUND: Snacking is associated with a higher daily energy intake and dietary guidelines recommend snacks of no more than 200 kcal for adults and 100 kcal for children. The present study examines the energy content, nutritional quality and price of single-serving snack food products sold by major supermarket and coffee shop chains in the UK. METHODS: Energy content, nutritional content and price of single-serving snack products were recorded in 2019 via the websites of 14 major chains (seven supermarkets; seven coffee shops). RESULTS: The mean energy content of all eligible snack products (n = 2283) was 186 kcal [95% confidence interval (CI) = 182-190]. The mean energy content of the snack products sold at coffee shops (n = 379; 282 kcal [95% CI = 269-295]) was significantly higher than the energy content of the snack products sold at supermarkets (n = 1904; 167 kcal [95% CI = 164-170]). Seventy nine % of supermarket snacks exceeded energy recommendations for children and 32% for adults. In coffee shops, 91% exceeded recommendations for children and 73% for adults. Forty one % of snacks were high in fat, 42% were high in saturated fat, 39% were high in sugar and 7% were high in salt. Cheaper snack products were more likely to be of lower nutritional quality. CONCLUSIONS: The high proportion of snack products that do not meet public health recommendations for energy content may contribute to the association between snacking and increased energy intake. Public health measures to increase the availability and reduce the price of snack products that meet public health energy content recommendations may reduce population-level obesity.

9.
Soft Matter ; 17(16): 4254-4265, 2021 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-33870384

RESUMO

Protein enrichment at specific membrane locations in cells is crucial for many cellular functions. It is well-recognized that the ability of some proteins to sense membrane curvature contributes partly to their enrichment in highly curved cellular membranes. In the past, different theoretical models have been developed to reveal the physical mechanisms underlying curvature-driven protein sorting. This review aims to provide a detailed discussion of the two continuous models that are based on the Helfrich elasticity energy, (1) the spontaneous curvature model and (2) the curvature mismatch model. These two models are commonly applied to describe experimental observations of protein sorting. We discuss how they can be used to explain the curvature-induced sorting data of two BAR proteins, amphiphysin and centaurin. We further discuss how membrane rigidity, and consequently the membrane curvature generated by BAR proteins, could influence protein organization on the curved membranes. Finally, we address future directions in extending these models to describe some cellular phenomena involving protein sorting.

10.
Molecules ; 26(7)2021 Apr 03.
Artigo em Inglês | MEDLINE | ID: mdl-33916717

RESUMO

The clustered regularly interspaced short palindromic repeats (CRISPR)/Cas-mediated genome editing system has recently been used for haploid production in plants. Haploid induction using the CRISPR/Cas system represents an attractive approach in cannabis, an economically important industrial, recreational, and medicinal plant. However, the CRISPR system requires the design of precise (on-target) single-guide RNA (sgRNA). Therefore, it is essential to predict off-target activity of the designed sgRNAs to avoid unexpected outcomes. The current study is aimed to assess the predictive ability of three machine learning (ML) algorithms (radial basis function (RBF), support vector machine (SVM), and random forest (RF)) alongside the ensemble-bagging (E-B) strategy by synergizing MIT and cutting frequency determination (CFD) scores to predict sgRNA off-target activity through in silico targeting a histone H3-like centromeric protein, HTR12, in cannabis. The RF algorithm exhibited the highest precision, recall, and F-measure compared to all the tested individual algorithms with values of 0.61, 0.64, and 0.62, respectively. We then used the RF algorithm as a meta-classifier for the E-B method, which led to an increased precision with an F-measure of 0.62 and 0.66, respectively. The E-B algorithm had the highest area under the precision recall curves (AUC-PRC; 0.74) and area under the receiver operating characteristic (ROC) curves (AUC-ROC; 0.71), displaying the success of using E-B as one of the common ensemble strategies. This study constitutes a foundational resource of utilizing ML models to predict gRNA off-target activities in cannabis.

11.
Nutrients ; 13(4)2021 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-33800575

RESUMO

In Botswana, there is limited data available on the health and nutritional status of the San People (also known as the Basarwa or Bushmen), an Indigenous minority group primarily living in the Ghanzi District. Our aim in this study was to assess anemia prevalence among and anthropometric indices of women and young children in Ghanzi District through a cross-sectional survey. We recruited 367 mother-child pairs (women 15-49 years and children 6-59 months) in nine randomly selected areas. A capillary blood sample was collected, and weight and height were measured. Hemoglobin (Hb) concentration was measured with use of a hemoglobinometer (HemoCue, AB), as per global recommendations. Overall, adjusted anemia prevalence was 12% in non-pregnant women (Hb < 120 g/L), 26% in pregnant women (Hb < 110 g/L), and 42% in children (Hb < 110 g/L), but it varied widely depending on whether or not the controversial factor of ethnicity was adjusted for (range of 6-26%, 22-30%, and 35-68% prevalence, respectively). Thirty-nine percent (n = 133/344) of non-pregnant women and 52% (n = 12/23) of pregnant women were underweight (BMI < 18.5 kg/m2). In children aged 6-23 months, 41% were underweight (weight-for-age z-score < -2 SD), 13% were wasted (weight-for-height z-score < -2 SD), and 65% were stunted (height-for-age z-score < -2 SD); in children aged 24-59 months, 57% were underweight, 13% were wasted, and 66% were stunted. Fifty-six percent (n = 205/367) of women self-reported smoking in any form (rolled cigarettes or snuffing). The high prevalence of smoking among women, underweight status among pregnant women, and anemia, stunting, and wasting among children is of the highest concern for public health and should be addressed in future health and nutrition programming.


Assuntos
Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Anemia/etnologia , Anemia/epidemiologia , População Rural/estatística & dados numéricos , Adolescente , Adulto , Grupo com Ancestrais do Continente Africano/etnologia , Antropometria , Botsuana/epidemiologia , Pré-Escolar , Estudos Transversais , Feminino , Transtornos do Crescimento/epidemiologia , Transtornos do Crescimento/etnologia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Gestantes/etnologia , Prevalência , Magreza/epidemiologia , Magreza/etnologia , Síndrome de Emaciação/epidemiologia , Síndrome de Emaciação/etnologia , Adulto Jovem
12.
Physiol Behav ; 237: 113434, 2021 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-33901529

RESUMO

BACKGROUND: Interoception refers to the process of identifying and listening to internal bodily signals, which may be a modifiable determinant of appetite regulation and weight gain. The objective was to examine whether the extent to which self-reported interoception is associated with higher BMI is explained by eating behavior traits. METHODS: UK adults (N = 1181, 49% female, 53% with overweight/obesity) completed validated self-report measures of interoception, habitual tendencies to eat in response to satiety signals (intuitive eating), emotional over-eating and other eating traits. RESULTS: Poorer self-reported ability to detect interoceptive signals (deficits in interoceptive accuracy) was predictive of higher BMI (r = - 0.07 (95% CI -0.13; -0.01), p < .05). In parallel mediation analyses, participants with poorer interoceptive accuracy were significantly less likely to report considering satiety signals when eating and this explained the cross-sectional association between interoceptive accuracy and higher BMI. There was also some evidence that participants with poorer interoceptive accuracy were more likely to report emotional overeating and this also in part explained why interoceptive accuracy was predictive of higher BMI. CONCLUSIONS: Deficits in interoception may decrease the likelihood that satiety signals are integrated into eating behaviour related decision making and in doing so contribute to higher BMI.

13.
Front Immunol ; 12: 598778, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33717077

RESUMO

Emerging infectious diseases (EIDs) caused by viruses are increasing in frequency, causing a high disease burden and mortality world-wide. The COVID-19 pandemic caused by the novel SARS-like coronavirus (SARS-CoV-2) underscores the need to innovate and accelerate the development of effective vaccination strategies against EIDs. Human leukocyte antigen (HLA) molecules play a central role in the immune system by determining the peptide repertoire displayed to the T-cell compartment. Genetic polymorphisms of the HLA system thus confer a strong variability in vaccine-induced immune responses and may complicate the selection of vaccine candidates, because the distribution and frequencies of HLA alleles are highly variable among different ethnic groups. Herein, we build on the emerging paradigm of rational epitope-based vaccine design, by describing an immunoinformatics tool (Predivac-3.0) for proteome-wide T-cell epitope discovery that accounts for ethnic-level variations in immune responsiveness. Predivac-3.0 implements both CD8+ and CD4+ T-cell epitope predictions based on HLA allele frequencies retrieved from the Allele Frequency Net Database. The tool was thoroughly assessed, proving comparable performances (AUC ~0.9) against four state-of-the-art pan-specific immunoinformatics methods capable of population-level analysis (NetMHCPan-4.0, Pickpocket, PSSMHCPan and SMM), as well as a strong accuracy on proteome-wide T-cell epitope predictions for HIV-specific immune responses in the Japanese population. The utility of the method was investigated for the COVID-19 pandemic, by performing in silico T-cell epitope mapping of the SARS-CoV-2 spike glycoprotein according to the ethnic context of the countries where the ChAdOx1 vaccine is currently initiating phase III clinical trials. Potentially immunodominant CD8+ and CD4+ T-cell epitopes and population coverages were predicted for each population (the Epitope Discovery mode), along with optimized sets of broadly recognized (promiscuous) T-cell epitopes maximizing coverage in the target populations (the Epitope Optimization mode). Population-specific epitope-rich regions (T-cell epitope clusters) were further predicted in protein antigens based on combined criteria of epitope density and population coverage. Overall, we conclude that Predivac-3.0 holds potential to contribute in the understanding of ethnic-level variations of vaccine-induced immune responsiveness and to guide the development of epitope-based next-generation vaccines against emerging pathogens, whose geographic distributions and populations in need of vaccinations are often well-defined for regional epidemics.


Assuntos
Linfócitos T CD4-Positivos/imunologia , Linfócitos T CD8-Positivos/imunologia , Epitopos de Linfócito T/metabolismo , Grupos Étnicos , Antígenos HLA/metabolismo , Proteômica/métodos , Glicoproteína da Espícula de Coronavírus/metabolismo , /epidemiologia , Doenças Transmissíveis Emergentes , Epitopos de Linfócito T/genética , Antígenos HLA/genética , Humanos , Imunogenicidade da Vacina , Aplicações da Informática Médica , Pandemias/prevenção & controle , Polimorfismo Genético , Ligação Proteica , Software , Glicoproteína da Espícula de Coronavírus/genética
15.
Pathology ; 53(3): 427-437, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33707006

RESUMO

Monoclonal antibody (mAb) therapy targeting CD38 and CD47 antigens expressed on cancer cells has transformed therapy options for patients with multiple myeloma as well as other haematological and non-haematological malignancies. While the on target effects of these new drugs highlight the promise of precision cancer therapeutics, the unintended, off target binding of drugs to red blood cells (RBCs) and platelets has required transfusion service laboratories (TSL) and immunohaematology reference laboratories (IRL) to innovate and rapidly set up processes and testing protocols to overcome the significant interference in routine pre-transfusion tests caused by these agents. Binding of anti-CD38 and anti-CD47 drugs to reagent RBCs leads to false positive pan-agglutination during the antihuman globulin phase of testing, making it difficult to rule out underlying alloantibodies, and leading to delays in setting up compatible units for RBC transfusion. Anti-CD47 agents can also interfere with ABO/Rh typing studies. Several methods to successfully mitigate interference have been described, such as treatment of reagent RBCs with reducing agents or enzymes, allogeneic RBC adsorption studies and drug specific neutralisation assays; all methods have limitations. TSLs should select an approach that best fits their workflow and expertise and takes into consideration their level of access to specialised outside testing, local blood supplier capabilities, and the type of patient population served. For platelet refractory patients, samples should be tested by platelet antibody assays that are known to be unaffected by drug therapy. RBC transfusion support for multiple myeloma patients receiving anti-CD38 or anti-CD47 drugs can be optimised by establishing good communication between the clinical teams and TSLs, building electronic notification processes, and ensuring timely completion of baseline pre-transfusion testing and RBC phenotype/genotype prior to starting therapy. Staff education, standardisation of laboratory mitigation measures, and implementation of testing algorithms that consider mAb-induced interference when working up a pan-agglutinin help to significantly decrease delays that would otherwise result if standard methods were employed to complete antibody identification studies.

16.
J Proteome Res ; 20(4): 1981-1985, 2021 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-33710902

RESUMO

Complex biological samples, in particular, in proteomics and metabolomics research, are often analyzed using mass spectrometry paired with liquid chromatography or gas chromatography. The chromatography stage adds a third dimension (retention time) to the usual 2D mass spectrometry output (mass/charge, detected ion counts). Experimental results are often discovered by complex computational analysis, but it is not always possible to know if the data has been correctly interpreted. To perform quality-control checks, it can often be helpful to verify the results by manually examining the raw data, and it is typically easier to understand the data in a graphical, rather than numerical, form. 3D graphics hardware is present in most modern computers but is rarely utilized by bioinformatics software, even when the data to be viewed are naturally 3D. lcmsWorld is new software that uses graphics hardware to quickly and smoothly examine and compare LC-MS data. A preprocessing step allows the software to subsequently access any area of the data instantly at multiple levels of detail. The data can then be freely navigated while the software automatically selects, loads, and displays the most appropriate detail. lcmsWorld is open source. Releases, source code, and example data files are available via https://github.com/PGB-LIV/lcmsWorld.

17.
JAMA ; 325(12): 1173-1184, 2021 03 23.
Artigo em Inglês | MEDLINE | ID: mdl-33755077

RESUMO

Importance: Although most critically ill patients receive invasive mechanical ventilation (IMV), few studies have characterized how IMV is discontinued in practice. Objective: To describe practice variation in IMV discontinuation internationally, associations between initial discontinuation events and outcomes, and factors associated with the use of select discontinuation strategies and failed initial spontaneous breathing trials (SBTs). Design, Setting, and Participants: Prospective, multinational, observational study of critically ill adults who received IMV for at least 24 hours from 142 intensive care units (ICUs) in 19 countries within 6 regions (27 in Canada, 23 in India, 22 in the UK, 26 in Europe, 21 in Australia/New Zealand, and 23 in the US). Exposures: Receiving IMV. Main Outcomes and Measures: Primary analyses characterized types of initial IMV discontinuation events (extubation, SBT, or tracheostomy) and associations with clinical outcomes (including duration of ventilation, ICU and hospital mortality, and ICU and hospital length of stay). Secondary analyses examined the associations between SBT outcome and SBT timing and clinical outcomes. Results: Among 1868 patients (median [interquartile range] age, 61.8 [48.9-73.1] years; 1173 [62.8%] men) 424 (22.7%) underwent direct extubation, 930 (49.8%) had an initial SBT (761 [81.8%] successful), 150 (8.0%) underwent direct tracheostomy, and 364 (19.5%) died before a weaning attempt. Across regions, there was variation in the use of written directives to guide care, daily screening, SBT techniques, ventilator modes, and the roles played by clinicians involved in weaning. Compared with initial direct extubation, patients who had an initial SBT had higher ICU mortality (20 [4.7%] vs 96 [10.3%]; absolute difference, 5.6% [95% CI, 2.6%-8.6%]), longer duration of ventilation (median of 2.9 vs 4.1 days; absolute difference, 1.2 days [95% CI, 0.7-1.6]), and longer ICU stay (median of 6.7 vs 8.1 days; absolute difference, 1.4 days [95% CI, 0.8-2.4]). Patients whose initial SBT failed (vs passed) had higher ICU mortality (29 [17.2%] vs 67 [8.8%]; absolute difference, 8.4% [95% CI, 2.0%-14.7%]), longer duration of ventilation (median of 6.1 vs 3.5 days; absolute difference, 2.6 days [95% CI, 1.6-3.6]), and longer ICU stay (median of 10.6 vs 7.7 days; absolute difference, 2.8 days [95% CI, 1.1-5.2]). Compared with patients who underwent early initial SBTs, patients who underwent late initial SBTs (>2.3 days after intubation) had longer duration of ventilation (median of 2.1 vs 6.1 days; absolute difference, 4.0 days [95% CI, 3.7-4.5]), longer ICU stay (median of 5.9 vs 10.8 days; absolute difference, 4.9 days [95% CI, 4.0-6.3]), and longer hospital stay (median of 14.3 vs 22.8 days; absolute difference, 8.5 days [95% CI, 6.0-11.0]). Conclusions and Relevance: In this observational study of invasive mechanical ventilation discontinuation in 142 ICUs in Canada, India, the UK, Europe, Australia/New Zealand, and the US from 2013 to 2016, weaning practices varied internationally. Trial Registration: ClinicalTrials.gov Identifier: NCT03955874.


Assuntos
Estado Terminal/terapia , Desmame do Respirador/métodos , Adulto , Idoso , Feminino , Humanos , Unidades de Terapia Intensiva , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Respiração Artificial , Resultado do Tratamento
18.
Sci Total Environ ; 778: 146286, 2021 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-33725601

RESUMO

Microbial activity strongly influences the stabilization of soil organic matter (SOM), and is affected by the abiotic properties within soil aggregates, which tend to differ between land uses. Here, we assessed the effects of SOM and pore geometry on the diversity and activity of microbial communities within aggregates formed under different land uses (undisturbed, plantation, pasture, and cropping). X-ray micro-computed tomography (µCT) revealed that macro-aggregates (2-8 mm) of undisturbed soils were porous, highly-connected, and had 200% more macro-pores compared with those from pasture and cropping soils. While the macro-aggregates of undisturbed soils had greater soil organic carbon (SOC) contents and N-acetyl ß-glucosaminidase, ß-glucosidase, and phosphatase activities, those of cropped soils harboured more diverse bacterial communities. Organic carbon was positively associated with the porosity of the macro-aggregates, which was negatively associated with microbial diversity and positively associated with enzyme activity. Thus, the biophysical processes in macro-aggregates may be important for SOC stabilization within the macro-aggregates.

19.
Matern Child Nutr ; : e13181, 2021 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-33780144

RESUMO

Little evidence exists concerning perceptions of anaemia in Ghanaian communities, which limits understanding of how to potentially improve health in settings with high anaemia prevalence. We explored lay perceptions of anaemia to understand local knowledge and beliefs and to provide an opportunity to inform interventions. A cross-sectional, qualitative study was conducted in selected communities in three regions of Ghana with high prevalence of anaemia. Forty-eight focus group discussions (FGDs) were conducted with adolescent girls, adult women of reproductive age and adult men (16 FGDs for each demographic group). Participants across the three demographic groups generally described anaemia as inadequate blood in the body and reported that poor diet, heat, alcohol intake, physiological factors and diseases such as malaria were the main causes of anaemia. Consequences of anaemia mentioned in the FGDs included dizziness, weight loss, loss of appetite and weakness. Prevention of anaemia was perceived to result from improved diet, avoidance of exposure to heat and improved sanitation to avoid diseases. The findings suggest that despite areas of convergence between lay and biomedical knowledge on the causes, consequences and prevention of anaemia, the burden of anaemia remains high in the study regions. This highlights a disconnect between local knowledge of anaemia and the health and nutrition behaviours needed to reduce its incidence. Effective interventions can be developed with and for communities that build upon existing knowledge while filling remaining knowledge gaps or misconceptions.

20.
Physiol Rep ; 9(5): e14790, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33661544

RESUMO

Prostaglandin (PG) E2  has been linked to increased inflammation and attenuated resistance exercise adaptations in skeletal muscle. Nonaspirin cyclooxygenase (COX) inhibitors have been shown to reduce these effects. This study examined the effect of low-dose aspirin on skeletal muscle COX production of PGE2 at rest and following resistance exercise. Skeletal muscle (vastus lateralis) biopsies were taken from six individuals (4 M/2 W) before and 3.5 hr after a single bout of resistance exercise for ex vivo PGE2 production under control and low (10 µM)- or standard (100 µM)-dose aspirin conditions. Sex-specific effects of aspirin were also examined by combining the current findings with our previous similar ex vivo skeletal muscle investigations (n = 20, 10 M/10 W). Low-dose aspirin inhibited skeletal muscle PGE2 production (p < 0.05). This inhibition was similar to standard-dose aspirin (p > 0.05) and was not influenced by resistance exercise (p > 0.05) (overall effect: -18 ± 5%). Men and women had similar uninhibited skeletal muscle PGE2 production at rest (men: 1.97 ± 0.33, women: 1.96 ± 0.29 pg/mg wet weight/min; p > 0.05). However, skeletal muscle of men was 60% more sensitive to aspirin inhibition than women (p < 0.05). In summary, the current findings 1) confirm low-dose aspirin inhibits the PGE2 /COX pathway in human skeletal muscle, 2) show that resistance exercise does not alter aspirin inhibitory efficacy, and 3) suggest the skeletal muscle of men and women could respond differently to long-term consumption of low-dose aspirin, one of the most common chronically consumed drugs in the world.

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