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1.
J Cell Sci ; 137(2)2024 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-38236161

RESUMO

The actin cytoskeleton plays a critical role in cell architecture and the control of fundamental processes including cell division, migration and survival. The dynamics and organisation of F-actin have been widely studied in a breadth of cell types on classical two-dimensional (2D) surfaces. Recent advances in optical microscopy have enabled interrogation of these cytoskeletal networks in cells within three-dimensional (3D) scaffolds, tissues and in vivo. Emerging studies indicate that the dimensionality experienced by cells has a profound impact on the structure and function of the cytoskeleton, with cells in 3D environments exhibiting cytoskeletal arrangements that differ to cells in 2D environments. However, the addition of a third (and fourth, with time) dimension leads to challenges in sample preparation, imaging and analysis, necessitating additional considerations to achieve the required signal-to-noise ratio and spatial and temporal resolution. Here, we summarise the current tools for imaging actin in a 3D context and highlight examples of the importance of this in understanding cytoskeletal biology and the challenges and opportunities in this domain.


Assuntos
Actinas , Citoesqueleto , Citoesqueleto de Actina , Microscopia , Microtúbulos
2.
EMBO J ; 40(17): e105603, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34254352

RESUMO

Variants identified in genome-wide association studies have implicated immune pathways in the development of Alzheimer's disease (AD). Here, we investigated the mechanistic basis for protection from AD associated with PLCγ2 R522, a rare coding variant of the PLCG2 gene. We studied the variant's role in macrophages and microglia of newly generated PLCG2-R522-expressing human induced pluripotent cell lines (hiPSC) and knockin mice, which exhibit normal endogenous PLCG2 expression. In all models, cells expressing the R522 mutation show a consistent non-redundant hyperfunctionality in the context of normal expression of other PLC isoforms. This manifests as enhanced release of cellular calcium ion stores in response to physiologically relevant stimuli like Fc-receptor ligation or exposure to Aß oligomers. Expression of the PLCγ2-R522 variant resulted in increased stimulus-dependent PIP2 depletion and reduced basal PIP2 levels in vivo. Furthermore, it was associated with impaired phagocytosis and enhanced endocytosis. PLCγ2 acts downstream of other AD-related factors, such as TREM2 and CSF1R, and alterations in its activity directly impact cell function. The inherent druggability of enzymes such as PLCγ2 raises the prospect of PLCγ2 manipulation as a future therapeutic approach in AD.


Assuntos
Doença de Alzheimer/genética , Endocitose , Fosfatidilinositol 4,5-Difosfato/metabolismo , Proteína Quinase C/genética , Peptídeos beta-Amiloides/metabolismo , Animais , Linhagem Celular , Células Cultivadas , Humanos , Macrófagos/metabolismo , Camundongos , Camundongos Endogâmicos C57BL , Mutação de Sentido Incorreto , Neuroglia/metabolismo , Proteína Quinase C/metabolismo
3.
Rheumatology (Oxford) ; 62(2): 804-814, 2023 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-35703945

RESUMO

OBJECTIVE: To describe 2-year trajectories of the clinical Juvenile Arthritis Disease Activity Score, 10 joints (cJADAS10) and associated baseline characteristics in patients with JIA. METHODS: JIA patients in the Childhood Arthritis and Rheumatology Research Alliance Registry enrolled within 3 months of diagnosis from 15 June 2015 to 6 December 2017 with at least two cJADAS10 scores and 24 months of follow-up were included. Latent growth curve models of cJADAS10 were analysed; a combination of Bayesian information criterion, posterior probabilities and clinical judgement was used to select model of best fit. RESULTS: Five trajectories were identified among the 746 included patients: High, Rapidly Decreasing (HRD) (n = 199, 26.7%); High, Slowly Decreasing (HSD) (n = 154, 20.6%); High, Increasing (HI) (n = 39, 5.2%); Moderate, Persistent (MP) (n = 218, 29.2%); and Moderate, Decreasing (MD) (n = 136, 18.2%). Most patients spent a significant portion of time at moderate to high disease activity levels. At baseline, HSD patients were more likely to be older, have a lower physician global assessment, normal inflammatory markers, longer time to first biologic, and have taken systemic steroids compared with HRD. Those with a HI trajectory were more likely to be ANA negative, have a longer time to first biologic, and less likely to be taking a conventional synthetic DMARD compared with HRD. MP patients were more likely to be older with lower household income, longer time to diagnosis, and markers of higher disease activity than those with a MD trajectory. CONCLUSIONS: Five trajectories of JIA disease activity, and associated baseline variables, were identified.


Assuntos
Antirreumáticos , Artrite Juvenil , Produtos Biológicos , Reumatologia , Humanos , Criança , Artrite Juvenil/diagnóstico , Teorema de Bayes , Antirreumáticos/uso terapêutico , Sistema de Registros , Produtos Biológicos/uso terapêutico
4.
J Microsc ; 291(1): 30-42, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-36639864

RESUMO

Multicellular tumour cell spheroids embedded within three-dimensional (3D) hydrogels or extracellular matrices (ECM) are widely used as models to study cancer growth and invasion. Standard methods to embed spheroids in 3D matrices result in random placement in space which limits the use of inverted fluorescence microscopy techniques, and thus the resolution that can be achieved to image molecular detail within the intact spheroid. Here, we leverage UV photolithography to microfabricate PDMS (polydimethylsiloxane) stamps that allow for generation of high-content, reproducible well-like structures in multiple different imaging chambers. Addition of multicellular tumour spheroids into stamped collagen structures allows for precise positioning of spheroids in 3D space for reproducible high-/super-resolution imaging. Embedded spheroids can be imaged live or fixed and are amenable to immunostaining, allowing for greater flexibility of experimental approaches. We describe the use of these spheroid imaging chambers to analyse cell invasion, cell-ECM interaction, ECM alignment, force-dependent intracellular protein dynamics and extension of fine actin-based protrusions with a variety of commonly used inverted microscope platforms. This method enables reproducible, high-/super-resolution live imaging of multiple tumour spheroids, that can be potentially extended to visualise organoids and other more complex 3D in vitro systems.


Assuntos
Neoplasias , Humanos , Neoplasias/diagnóstico por imagem , Esferoides Celulares/patologia , Colágeno , Matriz Extracelular
5.
Microb Ecol ; 85(4): 1527-1540, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-35840683

RESUMO

Arthropods can host well-developed microbial communities, and such microbes can degrade pesticides and confer tolerance to most types of pests. Two cultures of the stored-product mite Tyrophagus putrescentiae, one with a symbiotic microbiome containing Wolbachia and the other without Wolbachia, were compared on pesticide residue (organophosphate: pirimiphos-methyl and pyrethroid: deltamethrin, deltamethrin + piperonyl butoxide)-containing diets. The microbiomes from mite bodies, mite feces and debris from the spent mite diet were analyzed using barcode sequencing. Pesticide tolerance was different among mite cultures and organophosphate and pyrethroid pesticides. The pesticide residues influenced the microbiome composition in both cultures but without any remarkable trend for mite cultures with and without Wolbachia. The most influenced bacterial taxa were Bartonella-like and Bacillus for both cultures and Wolbachia for the culture containing this symbiont. However, there was no direct evidence of any effect of Wolbachia on pesticide tolerance. The high pesticide concentration residues in diets reduced Wolbachia, Bartonella-like and Bacillus in mites of the symbiotic culture. This effect was low for Bartonella-like and Bacillus in the asymbiotic microbiome culture. The results showed that the microbiomes of mites are affected by pesticide residues in the diets, but the effect is not systemic. No actual detoxification effect by the microbiome was observed for the tested pesticides.


Assuntos
Acaridae , Bacillus , Bartonella , Microbiota , Ácaros , Resíduos de Praguicidas , Praguicidas , Piretrinas , Animais , Acaridae/microbiologia , Praguicidas/farmacologia , Resíduos de Praguicidas/farmacologia , Ácaros/microbiologia , Bacillus/genética , Piretrinas/farmacologia
6.
Alcohol Alcohol ; 58(5): 561-564, 2023 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-37449462

RESUMO

This study aimed to examine characteristics associated with discharge against medical advice from the hospital in alcohol withdrawal patients, supporting the work of hospital staff and Alcohol Care Teams and identifying characteristics that may help target patients most likely to discharge against medical advice. We used Hospital Episode Statistics Data to identify demographic and clinical variables and compare these in alcohol withdrawal patients who discharged against medical advice from hospital, compared with those who were discharged by the clinical team. Factors significantly associated with alcohol withdrawal patients discharging against medical advice from hospital were: being admitted as an emergency; discharged on a weekend; living with no fixed abode; being male; being younger and having a shorter length of stay. This study identifies characteristics that can be used to support acute hospitals and Alcohol Care Teams, particularly in the allocation of resources to reduce discharges against medical advice and subsequent readmissions to the hospital. Particular consideration should be given to clinical provision in hospitals in emergency departments and on weekends, and also those patients who are admitted and are of no fixed abode.


Assuntos
Alcoolismo , Síndrome de Abstinência a Substâncias , Humanos , Masculino , Feminino , Alta do Paciente , Recusa do Paciente ao Tratamento , Alcoolismo/epidemiologia , Alcoolismo/terapia , Síndrome de Abstinência a Substâncias/epidemiologia , Síndrome de Abstinência a Substâncias/terapia , Hospitalização , Estudos Retrospectivos
7.
BMC Microbiol ; 22(1): 252, 2022 10 19.
Artigo em Inglês | MEDLINE | ID: mdl-36261789

RESUMO

BACKGROUND: The contribution of the microbiome to pesticide breakdown in agricultural pests remains unclear. We analyzed the effect of pirimiphos-methyl (PM) on four geographically different cultures of the stored product pest mite Acarus siro (6 L, 6Tu, 6Tk and 6Z) under laboratory experiments. The effect of PM on mite mortality in the impregnated filter paper test was compared. RESULTS: The mite sensitivity to PM decreased in the order of 6 L, 6Tu, 6Tk, and 6Z. Then, the mites were cultured on PM residues (0.0125 and 1.25 µg·g-1), and population growth was compared to the control after 21 days of exposure. The comparison showed two situations: (i) increasing population growth for the most sensitive cultures (6 L and 6Tu), and (ii) no effect on mite population growth for tolerant cultures (6Z and 6Tk). The microbiome of mites was analyzed by quantification of 16S DNA copies based on quantitative polymerase chain reaction (qPCR) and by barcode sequencing of the V4 fragment of 16S DNA on samples of 30 individuals from the control and PM residues. The microbiome comprised primarily Solitalea-like organisms in all cultures, except for 6Z, followed by Bacillus, Staphylococcus, and Lactobacillus. The microbiomes of mite cultures did not change with increasing population density. The microbiome of cultures without any differences in population density showed differences in the microbiome composition. A Sodalis-like symbiont replaced Solitalea in the 1.25 µg·g-1 PM in the 6Tk culture. Sodalis and Bacillus prevailed in the microbiomes of PM-treated mites of 6Z culture, while Solitalea was almost absent. CONCLUSION: The results showed that the microbiome of A. siro differs in composition and in response to PM residues in the diet. The results indicate that Sodalis-like symbionts can help recover mites from pesticide-induced stress.


Assuntos
Acaridae , Microbiota , Ácaros , Resíduos de Praguicidas , Humanos , Animais , Bacteroidetes
8.
FASEB J ; 35(2): e21338, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33428278

RESUMO

Pregnancy complications associated with prenatal hypoxia lead to increased placental oxidative stress. Previous studies suggest that prenatal hypoxia can reduce mitochondrial respiratory capacity and mitochondrial fusion, which could lead to placental dysfunction and impaired fetal development. We developed a placenta-targeted treatment strategy using a mitochondrial antioxidant, MitoQ, encapsulated into nanoparticles (nMitoQ) to reduce placental oxidative stress and (indirectly) improve fetal outcomes. We hypothesized that, in a rat model of prenatal hypoxia, nMitoQ improves placental mitochondrial function and promotes mitochondrial fusion in both male and female placentae. Pregnant rats were treated with saline or nMitoQ on gestational day (GD) 15 and exposed to normoxia (21% O2 ) or hypoxia (11% O2 ) from GD15-21. On GD21, male and female placental labyrinth zones were collected for mitochondrial respirometry assessments, mitochondrial content, and markers of mitochondrial biogenesis, fusion and fission. Prenatal hypoxia reduced complex IV activity and fusion in male placentae, while nMitoQ improved complex IV activity in hypoxic male placentae. In female placentae, prenatal hypoxia decreased respiration through the S-pathway (complex II) and increased N-pathway (complex I) respiration, while nMitoQ increased fusion in hypoxic female placentae. No changes in mitochondrial content, biogenesis or fission were found. In conclusion, nMitoQ improved placental mitochondrial function in male and female placentae from fetuses exposed to prenatal hypoxia, which may contribute to improved placental function. However, the mechanisms (ie, changes in mitochondrial respiratory capacity and mitochondrial fusion) were distinct between the sexes. Treatment strategies targeted against placental oxidative stress could improve placental mitochondrial function in complicated pregnancies.


Assuntos
Antioxidantes/uso terapêutico , Hipóxia Fetal/tratamento farmacológico , Mitocôndrias/efeitos dos fármacos , Nanopartículas/química , Compostos Organofosforados/uso terapêutico , Placenta/efeitos dos fármacos , Ubiquinona/análogos & derivados , Animais , Antioxidantes/administração & dosagem , Antioxidantes/farmacologia , Respiração Celular , Feminino , Masculino , Mitocôndrias/metabolismo , Dinâmica Mitocondrial , Compostos Organofosforados/administração & dosagem , Compostos Organofosforados/farmacologia , Placenta/metabolismo , Gravidez , Ratos , Ratos Sprague-Dawley , Fatores Sexuais , Ubiquinona/administração & dosagem , Ubiquinona/farmacologia , Ubiquinona/uso terapêutico
9.
Pestic Biochem Physiol ; 184: 105132, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35715070

RESUMO

Deltamethrin is one of the most effective pyrethroid compounds used in stored product protection to control a wide range of pests. However, the development of resistance to deltamethrin in many pest species has been reported and useful research to overcome this problem is required. The present study investigated the possible synergistic effect of a commercial formulation of a mixture of the short chain fatty acids, octanoic, nonanoic and decanoic acid, in a formulation called "C8910" on the lethal activity of deltamethrin against susceptible (Lab-S) and relatively pyrethroid-resistant (Pyr-R) strains of T. castaneum. The possible mechanisms of synergism were studied by investigating the inhibitory effect of C8910 on the activity of detoxification enzymes including cytochrome P450s, esterases, and glutathione S-transferases (GST). In addition, the possible role of C8910 in enhancement of cuticular penetration of deltamethrin through insect cuticle was studied using GC analysis. The results showed that C8910 enhanced the toxicity of deltamethrin at mixing ratios of 1:5 and 1:10 against the Lab-S strain after 24 and 48 h of exposure, and synergistic factors (SF) ranged between 5.69 and 13.59. C8910 also showed greater synergism on the deltamethrin toxicity against the resistant strain than the susceptible one after 24 and 48 h of treatment at 1:5 and 1:10 ratios with SF values ranging from 22.82 and 47.16. C8910 showed strong inhibition of cytochrome P450 of rat microsomal fraction with IC50 value of 6.24 mM. Meanwhile, C8910 inhibited the activity of general esterases in Lab-S and Pyr-R strains with IC50 values of 26.22 and 51.73 mM, respectively. However, weak inhibition of GST activity was observed with inhibition of 52.0 and 22.6% at concentration of 100 mM of C8910 for Lab-S and Pyr-R, respectively. In addition, the results showed no significant difference between the unpenetrated amounts of deltamethrin when insects were treated with deltamethrin alone or with deltamethrin+C8910 (1:20) through the insect cuticle. Results suggested that the synergism between C8910 and deltamethrin could be related to the ability of C8910 to inhibit the detoxification enzymes such as cytochrome P450 and esterases. Therefore, C8910 could be a promising synergist to enhance deltamethrin toxicity and to be a possible natural alternative for conventional synergists such as piperonyl butoxide.


Assuntos
Besouros , Inseticidas , Piretrinas , Tribolium , Animais , Sistema Enzimático do Citocromo P-450 , Esterases , Ácidos Graxos Voláteis/farmacologia , Resistência a Inseticidas , Inseticidas/toxicidade , Nitrilas/farmacologia , Piretrinas/farmacologia , Ratos
10.
Alcohol Alcohol ; 56(1): 28-33, 2021 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-32885812

RESUMO

AIMS: We assessed the relationship between specialist and non-specialist admissions for alcohol withdrawal since the introduction of the UK government Health and Social Care Act in 2012. METHODS: Using publicly available national data sets from 2009 to 2019, we compared the number of alcohol withdrawal admissions and estimated costs in specialist and non-specialist treatment settings. RESULTS: A significant negative correlation providing strong evidence of an association was observed between the fall in specialist and rise in non-specialist admissions. Significant cost reductions within specialist services were displaced to non-specialist settings. CONCLUSIONS: The shift in demand from specialist to non-specialist alcohol admissions due to policy changes in England should be reversed by specialist workforce investment to improve outcomes. In the meantime, non-specialist services and staff must be resourced and equipped to meet the complex needs of these service users.


Assuntos
Alcoolismo/epidemiologia , Custos de Cuidados de Saúde , Hospitalização/estatística & dados numéricos , Especialização , Síndrome de Abstinência a Substâncias/epidemiologia , Alcoolismo/economia , Alcoolismo/terapia , Depressores do Sistema Nervoso Central/efeitos adversos , Inglaterra/epidemiologia , Etanol/efeitos adversos , Unidades Hospitalares , Hospitalização/economia , Humanos , Síndrome de Abstinência a Substâncias/economia , Síndrome de Abstinência a Substâncias/etiologia , Síndrome de Abstinência a Substâncias/terapia
11.
Annu Rev Entomol ; 65: 333-350, 2020 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-31610132

RESUMO

Development of resistance in major grain insect pest species to the key fumigant phosphine (hydrogen phosphide) across the globe has put the viability and sustainability of phosphine in jeopardy. The resistance problem has been aggravated over the past two decades, due mostly to the lack of suitable alternatives matching the major attributes of phosphine, including its low price, ease of application, proven effectiveness against a broad pest spectrum, compatibility with most storage conditions, and international acceptance as a residue-free treatment. In this review, we critically analyze the published literature in the area of phosphine resistance with special emphasis on the methods available for detection of resistance, the genetic basis of resistance development, key management strategies, and research gaps that need to be addressed.


Assuntos
Insetos/genética , Inseticidas , Fosfinas , Animais , Parasitologia de Alimentos , Fumigação , Controle de Insetos , Resistência a Inseticidas/genética
12.
Exp Physiol ; 105(9): 1507-1514, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32749725

RESUMO

NEW FINDINGS: What is the central question of this study? Does treatment of hypoxic dams with a placenta-targeted antioxidant prevent the release of placenta-derived factors that impair maturation or growth of fetal cardiomyocytes in vitro? What is the main finding and its importance? Factors released from hypoxic placentae impaired fetal cardiomyocyte maturation (induced terminal differentiation) and growth (increased cell size) in vitro, which was prevented by maternal treatment with a placenta-targeted antioxidant (nMitoQ). Moreover, there were no sex differences in the effects of placental factors on fetal cardiomyocyte maturation and growth. Overall, our data suggest that treatment targeted against placental oxidative stress could prevent fetal programming of cardiac diseases via the release of placental factors. ABSTRACT: Pregnancy complications associated with placental oxidative stress may impair fetal organ development through the release of placenta-derived factors into the fetal circulation. We assessed the effect of factors secreted from placentae previously exposed to prenatal hypoxia on fetal cardiomyocyte development and developed a treatment strategy that targets placental oxidative stress by encapsulating the antioxidant MitoQ into nanoparticles (nMitoQ). We used a rat model of prenatal hypoxia (gestational day (GD) 15-21), which was treated with saline or nMitoQ on GD15. On GD21, placentae were harvested, placed in culture, and conditioned medium (containing placenta-derived factors) was collected after 24 h. This conditioned medium was then added to cultured cardiomyocytes from control dam fetuses. Conditioned medium from prenatally hypoxic placentae increased the percentage of binucleated cardiomyocytes (marker of terminal differentiation) and the size of mononucleated and binucleated cardiomyocytes (sign of hypertrophy), effects that were prevented by nMitoQ treatment. Our data suggest that factors derived from placentae previously exposed to prenatal hypoxia lead to abnormal fetal cardiomyocyte development, and show that treatment against placental oxidative stress may prevent fetal programming of cardiac disease.


Assuntos
Antioxidantes/farmacologia , Desenvolvimento Fetal/efeitos dos fármacos , Hipóxia/tratamento farmacológico , Miócitos Cardíacos/fisiologia , Placenta/fisiologia , Animais , Células Cultivadas , Meios de Cultivo Condicionados , Feminino , Masculino , Compostos Organofosforados/farmacologia , Estresse Oxidativo , Gravidez , Ratos , Ratos Sprague-Dawley , Ubiquinona/análogos & derivados , Ubiquinona/farmacologia
13.
Alcohol Alcohol ; 55(4): 395-400, 2020 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-32318727

RESUMO

AIMS: The UK government aims to develop alcohol care teams (ACTs) that provide care for alcohol dependence in general hospital settings. Service descriptors have been identified to support the development of ACTs. The aim of this study was to use Delphi panel principles to identify the clinical competencies required to provide these elements of service. METHODS: We formed an expert consensus panel of 24 senior clinical alcohol practitioners, leaders and experts by experience drawn from all regions of England. The study was divided into three distinct phases: (a) a review and synthesis of current literature in this area, (b) a face-to-face meeting of the expert panel and (c) subsequent iterations to refine the competencies until consensus was reached. RESULTS: Our initial search strategy resulted in 555 competency statements being extracted from a range of national clinical professional and occupational standards and other sources. The research team refined these statements to 98 competencies in advance of the expert meeting. The panel identified 14 additional statements and reduced the number of competencies to 78. Subsequent iterations finalized 72 competencies across the 8 service descriptors. CONCLUSIONS: Drawing on the existing published resources and clinical experience, the expert panel has provided consensus on the core clinical competencies required for alcohol care teams in caring for hospitalized patients with alcohol use disorders. Whilst it is acknowledged that the range of current provision is variable, these competencies provide a template for clinical practice and the development of multidisciplinary ACTs.


Assuntos
Alcoolismo/terapia , Competência Clínica , Hospitalização , Consenso , Técnica Delphi , Inglaterra , Feminino , Humanos , Masculino , Medicina Estatal
14.
Annu Rev Entomol ; 64: 131-148, 2019 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-30285491

RESUMO

The khapra beetle, Trogoderma granarium, is a voracious feeder of stored products and is considered one of the most important quarantine pests globally. Its ability to survive for long periods under extreme conditions facilitates its spread through international commerce, which has led to invasions of new geographic regions. The khapra beetle is an important quarantine pest for many countries, including the major wheat-producing countries the United States, Canada, Russia, and Australia, and has been classified as one of the 100 worst invasive species worldwide. This species cannot always be controlled by insecticides and other nonchemical methods that are usually effective against other pests of stored products, particularly owing to its diapausing late larval stage. It can rapidly develop at elevated temperatures and under dry conditions, which are not favorable for many major stored-product insects. We synthesize key published work to draw attention to advances in biology, detection and control of the khapra beetle, and directions to consider for future research.


Assuntos
Besouros , Grão Comestível/parasitologia , Controle de Insetos , Espécies Introduzidas , Animais , Abastecimento de Alimentos
15.
Alcohol Alcohol ; 54(5): 516-524, 2019 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-33724349

RESUMO

AIMS: This study aims to estimate the prevalence and burden of alcohol disorders on Emergency Department (ED) and hospital inpatients in England through the exploratory analysis of NHS data. METHODS: ED attendances and admission data were linked using hospital episode statistics. Diagnoses were preserved at a patient level to identify individuals who had an alcohol attributable diagnosis. Four groups were identified; a) individuals with no alcohol disorder (NAD), b) acute alcohol disorder (AAD), c) chronic alcohol disorder (CAD) and d) those with any alcohol disorder (AD) (b) and c) combined). Associations between ED diagnosis and alcohol disorders were examined using logistic regression adjusted for hospital provider, age and sex. Non-parametric tests were employed examining ED and hospital service use. Cost differences by group was explored using a propensity scored match sample. RESULTS: Of the 1.2million subjects 6.7% were identified as having one or more AD accounting for 11.7% of ED attendances, 9.2% of hospital admissions and 7.2% total bed days. Bootstrapped derived means identified that hospital service use varied significantly between AAD and CAD. Whilst AAD accounted for greater attendances than NAD (2.78; 95% CI 2.680-2.879) those with CAD accounted for even greater attendances (4.33; 95% CI. 4.136-4.515), admissions (2.56; 95% CI. 2.502-2.625) and total bed days (15.14; 95% CI. 14.716-15.559). CONCLUSIONS: AD place a disproportionate impact on hospital services with CAD exerting the greatest burden on hospital utilization. The complexity and burden of CAD suggests this group should be a priority for intervention.

16.
J Public Health (Oxf) ; 41(1): e53-e60, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-29590416

RESUMO

OBJECTIVE: To estimate and compare the optimal cut-off score of Alcohol Use Disorders Identification Test (AUDIT) and AUDIT-C in identifying at-risk alcohol consumption, heavy episodic alcohol use, ICD-10 alcohol abuse and alcohol dependence in adolescents attending ED in England. DESIGN: Opportunistic cross-sectional survey. SETTING: 10 emergency departments across England. PARTICIPANTS: Adolescents (n = 5377) aged between their 10th and 18th birthday who attended emergency departments between December 2012 and May 2013. MEASURES: Scores on the AUDIT and AUDIT-C. At-risk alcohol consumption and monthly episodic alcohol consumption in the past 3 months were derived using the time-line follow back method. Alcohol abuse and alcohol dependence was assessed in accordance with ICD-10 criteria using the MINI-KID. FINDINGS: AUDIT-C with a score of 3 was more effective for at-risk alcohol use (AUC 0.81; sensitivity 87%, specificity 97%), heavy episodic use (0.84; 76%, 98%) and alcohol abuse (0.98; 91%, 90%). AUDIT with a score of 7 was more effective in identifying alcohol dependence (0.92; 96%, 94%). CONCLUSIONS: The 3-item AUDIT-C is more effective than AUDIT in screening adolescents for at-risk alcohol use, heavy episodic alcohol use and alcohol abuse. AUDIT is more effective than AUDIT-C for the identification of alcohol dependence.


Assuntos
Alcoolismo/diagnóstico , Escalas de Graduação Psiquiátrica/normas , Adolescente , Alcoolismo/epidemiologia , Criança , Estudos Transversais , Serviço Hospitalar de Emergência , Inglaterra/epidemiologia , Feminino , Humanos , Masculino , Sensibilidade e Especificidade
18.
Annu Rev Entomol ; 62: 379-397, 2017 01 31.
Artigo em Inglês | MEDLINE | ID: mdl-28141965

RESUMO

Traditional methods of stored-product pest control were initially passed from generation to generation. Ancient literature and archaeology reveal hermetic sealing, burning sulfur, desiccant dusts, and toxic botanicals as early control methods. Whereas traditional nonchemical methods were subsequently replaced by synthetic chemicals, other traditional methods were improved and integrated with key modern pesticides. Modern stored-product integrated pest management (IPM) makes decisions using knowledge of population dynamics and threshold insect densities. IPM programs are now being fine-tuned to meet regulatory and market standards. Better sampling methods and insights from life histories and ecological studies have been used to optimize the timing of pest management. Over the past 100 years, research on stored-product insects has shifted from being largely concentrated within 10 countries to being distributed across 65 countries. Although the components of IPM programs have been well researched, more research is needed on how these components can be combined to improve effectiveness and assure the security of postharvest food as the human population increases.


Assuntos
Entomologia/métodos , Abastecimento de Alimentos , Controle de Insetos/métodos , Insetos , Animais , Controle Biológico de Vetores/métodos
19.
Epilepsia ; 58(9): 1493-1501, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28632329

RESUMO

A recent article by Farrell et al. characterizes the phenomenon, mechanisms, and treatment of a local and severe hypoperfusion/hypoxia event that occurs in brain regions following a focal seizure. Given the well-established role of cerebral ischemia/hypoxia in brain damage and behavioral dysfunction in other clinical settings (e.g., stroke, cerebral vasospasm), we put forward a new theory: postictal hypoperfusion/hypoxia is responsible for the negative consequences associated with seizures. Fortunately, inhibition of two separate molecular targets, cyclooxygenase-2 (COX-2) and l-type calcium channels, can prevent the expression of postictal hypoperfusion/hypoxia. These inhibitors are important experimental tools used to separate the seizure from the resulting hypoperfusion/hypoxia and can allow researchers to address the contribution of this phenomenon to negative outcomes associated with seizures. Herein we address the implications of this postictal stroke-like event in acute behavioral dysfunction (e.g., Todd's paresis) and sudden unexpected death in epilepsy (SUDEP). Moreover, anatomic alterations such as increased blood-brain barrier permeability, glial activation, central inflammation, and neuronal loss could also be a consequence of repeated hypoperfusion/hypoxic events and, in turn, underlie chronic interictal cognitive and behavioral comorbidities (e.g., memory deficits, anxiety, depression, and psychosis) and exacerbate epileptogenesis. Thus these seemingly disparate and clinically important observations may share a common point of origin: postictal hypoperfusion/hypoxia.


Assuntos
Hipóxia Encefálica/fisiopatologia , Convulsões/fisiopatologia , Animais , Encéfalo/irrigação sanguínea , Encéfalo/fisiopatologia , Canais de Cálcio Tipo L/metabolismo , Ciclo-Oxigenase 2/metabolismo , Humanos , Modelos Biológicos , Convulsões/complicações
20.
Nature ; 529(7586): 294-5, 2016 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-26791718
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