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2.
Rev Sci Instrum ; 95(8)2024 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-39133088

RESUMEN

Protons from the Los Alamos Neutron Science Center have been used for pulsed radiography in dynamic experiments for the past 25 years. Pulses of protons are imaged on a scintillator, and the light from these images is captured by fast gated cameras. The need for fast, bright scintillators has led to some compromises in image quality due to tiling the scintillators and backgrounds with totally internally reflected light. We show how large-grain scintillator screens, made using a thin plastic binder, solve these problems.

3.
Rev Sci Instrum ; 95(8)2024 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-39158394

RESUMEN

Magnetically confined plasma experiments generate a wealth of spectroscopic data. The first step toward extracting physical parameters is to fit a spectral model to the often complex spectra. The CXSFIT (Charge eXchange Spectroscopy FITting) spectral fitting code was originally developed for fitting charge exchange spectra on JET from the late 1980s onward and has been further developed over decades to keep up with the needs of the users. The primary use is to efficiently fit a large number of spectra with many constrained Gaussian spectral lines of which the physical parameters can be coupled in a user-friendly manner. More recent additions to the code include time-dependent couplings between parameters, flexible background subtraction, and a non-linear coupling scheme between fit parameters. The latter was a pre-requisite for implementing Zeeman and motional Stark effect multiplets in the library of spectral features. The ability to save and replay "fit recipes," even when multiple iterations are required, has ensured the traceability of the results and is one of the keys to the longevity and success of the code. The code is also in use on other tokamaks (AUG, ST-40) and to fit data from other spectroscopic diagnostics on JET. In this paper, we document the current capabilities and philosophy behind the structure of the code, including some of the algorithms used to calculate spectral features numerically efficiently. We also provide an outline of how CXSFIT could be transferred into a framework that would be able to meet the spectral fitting requirements of future devices, such as ITER.

4.
Addict Behav ; 158: 108110, 2024 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-39089195

RESUMEN

OBJECTIVE: The current study was a systematic review and meta-analysis of cognitive behavioral treatment (CBT) for problem gambling and gambling disorder and whether it produced different outcomes than minimal or no treatment controls on three putative change mechanisms: 1) gambling cognitions, 2) coping, and 3) self-efficacy. METHOD: Studies were identified from five bibliographic databases (i.e., Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Embase, PsycINFO, and PubMed). Included studies were randomized controlled trials of CBT that included posttreatment data on putative mechanisms. Between-group Hedges's g effect sizes were calculated to examine outcomes of CBT relative to minimal or no treatment control on gambling cognitions, coping, and self-efficacy at posttreatment. Risk of bias was determined using the Cochrane Risk of Bias tool. RESULTS: Fifteen studies, representing 1,536 participants, were eligible for analysis. Participants in CBT had more favorable gambling cognitions (g = -0.41), coping behaviors (g = 0.27), and self-efficacy (g = 1.12) at posttreatment than minimal or no treatment control. CONCLUSIONS: Results of the current study provided preliminary support for the effectiveness of CBT on three putative mechanisms of change among individuals experiencing problem gambling and gambling disorder. Although the results were promising, there was significant heterogeneity in the magnitude of effect sizes for all three outcomes, and outcomes were not consistently assessed with psychometrically established assessment tools.


Asunto(s)
Adaptación Psicológica , Terapia Cognitivo-Conductual , Juego de Azar , Autoeficacia , Humanos , Juego de Azar/psicología , Juego de Azar/terapia , Terapia Cognitivo-Conductual/métodos , Cognición , Resultado del Tratamiento
5.
Artículo en Inglés | MEDLINE | ID: mdl-39187648

RESUMEN

Psychologists in academic medicine face pressure to juggle multiple roles, and research is often limited by a lack of available resources and funding. In other academic settings, student-led psychology research teams that utilize a tiered mentorship approach are able to produce advances in meaningful research while supporting the development of future professionals in the field. This article identifies the barriers of implementing a tiered mentorship model into an academic medicine setting and reviews a case study of how the model can be effectively adapted and evaluated to promote a self-sustaining, student-led psychology research team.

6.
Metabolomics ; 20(4): 82, 2024 Jul 27.
Artículo en Inglés | MEDLINE | ID: mdl-39066903

RESUMEN

BACKGROUND: Dietary habits significantly influence the risks of type 2 diabetes and cardiovascular disease. Through metabolomics, we've previously measured plasma metabolites to gauge dietary quality, introducing a healthy dietary metabolic signature (HDMS) linked to a decreased risk of future type 2 diabetes and coronary artery disease. OBJECTIVES: To assess the impact of a 6-day dietary intervention on plasma metabolites and the HDMS. METHODS: Fifty-nine Swedish participants (71% women, mean age 69 years) underwent a 6-day Mediterranean diet (MD) intervention in Italy's Cilento region. All meals, crafted from local recipes and ingredients, were provided. Metabolite profiling pre- and post-intervention was conducted with a UHPLC-QTOF. Alterations in metabolite levels and the HDMS were examined using paired T-test. RESULTS: The MD intervention notably enhanced the HDMS across participants (mean increase: 1.3 standard deviations (SD), 95% CI 1.1-1.4, p = 6E-25). Out of 109 metabolites, 66 exhibited significant alterations (fdr adjusted p < 0.05). Among the 10 most significant changes, increases were observed in several diet related metabolites such as pipecolate, hippurate, caffeine, homostachydrine, acylcarnitine C11:0, acetylornithine, beta-carotene and 7-methylguanine. The most significant decreases manifested in piperine and 3-methylhistidine. CONCLUSIONS: The HDMS, which is linked to a healthy diet and inversely associated with cardiometabolic disease, was significantly improved by the 6-day Mediterranean diet intervention. Notably, metabolite markers previously shown to be indicative of the intake of vegetables, fruits, grains, and legumes increased, while markers previously associated with red meat consumption decreased. These findings highlight the potential of short-term dietary interventions to induce significant changes in plasma metabolite profiles.


Asunto(s)
Dieta Mediterránea , Humanos , Femenino , Proyectos Piloto , Anciano , Masculino , Persona de Mediana Edad , Metabolómica/métodos , Metaboloma , Diabetes Mellitus Tipo 2/dietoterapia , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/metabolismo , Suecia
7.
Cannabis ; 7(2): 150-162, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38975592

RESUMEN

Emerging research shows that many individuals commonly consume cannabis while gambling. However, individuals' expectations for how cannabis consumption will impact their gambling behavior remain unknown. Participants who gambled weekly (N = 472) were recruited from Amazon Mechanical Turk and completed assessments of gambling behaviors, cannabis consumption, and expectations about the influence of cannabis on gambling. Almost all participants (94%) screened positive for problem gambling. Over half of participants (55%) reported lifetime cannabis consumption, and almost all those participants (99%) reported gambling under the influence of cannabis (GUIC) in the past month. Most participants agreed with positive expectations of gambling; they expected that they would feel calmer when under the influence of cannabis (61.4%), that gambling would be more enjoyable (61.0%), and that their gambling skills would increase when GUIC (60.6%). At the same time, most participants also agreed with negative expectations of GUIC. They expected cannabis use would make them more careless (56.4%), more anxious (54.8%), and less able to concentrate (53.7%) while gambling. Negative cannabis expectancies were significantly associated with the severity of cannabis consumption. Both positive and negative cannabis expectancies were significantly associated with gambling problems and time spent gambling under the influence of cannabis. These findings indicate that expectations may influence the decision to consume cannabis and gamble simultaneously. This study contributes to the need for addressing cannabis expectations during treatment of gambling problems.

8.
West Afr J Med ; 41(4): 436-451, 2024 Apr 30.
Artículo en Inglés | MEDLINE | ID: mdl-39003518

RESUMEN

INTRODUCTION: Community-based prevalence studies are known to be more accurate than hospital-based records. However, such community-based prevalence studies are uncommon in low- and middle-income countries including Nigeria. Allocation of resources and prioritization of health care needs by policy makers require data from such community-based studies to be meaningful and sustainable. This study aims to assess the prevalence of common surgical conditions amongst adults in Nigeria. METHODS: A descriptive cross-sectional community-based study to determine the prevalence of congenital and acquired surgical conditions in adults in a mixed rural-urban area of Lagos was conducted. The study population comprised resident members in the Ikorodu Local Government Area (LGA) of Lagos State. Data was collected using a modified version of the interviewer-administered questionnaire, the Surgeons OverSeas Assessment of Surgical Need (SOSAS) survey tool. Data was analysed using the REDCap analytic tool. RESULTS: Eight hundred and fifty-six households were surveyed with a yield of 1,992 adults. There were 95 adults who complained of surgical conditions giving a prevalence rate of 5%. Vast majority of reported conditions were acquired deformities (n=94) while only 1 congenital deformity was reported. Others included breast lumps, anterior neck swelling, and groin swellings. CONCLUSION: The most common surgical complaints in our setting among adults were acquired conditions of the extremities and open wounds/sores. With an estimated population of 90 million adults and approximately 1,200 orthopaedic and general surgeons respectively, the surgeon-to-affected population ratio is 1:10,000. There is a large gap to be filled in terms of surgical manpower development.


INTRODUCTION: Les études de prévalence communautaires sont connues pour être plus précises que les dossiers hospitaliers. Cependant, de telles études de prévalence communautaires sont rares dans les pays à revenu faible et intermédiaire, y compris le Nigeria. L'allocation des ressources et la priorisation des besoins de santé par les décideurs nécessitent des données issues de telles études communautaires pour être significatives et durables. Cette étude vise à évaluer la prévalence des affections chirurgicales courantes chez les adultes au Nigeria. MÉTHODES: Une étude descriptive transversale basée sur la communauté pour déterminer la prévalence des conditions chirurgicales congénitales et acquises chez les adultes dans une zone rurale-urbaine mixte de Lagos a été menée. La population étudiée comprenait des membres résidents de la zone de gouvernement local (LGA) d'Ikorodu, dans l'État de Lagos. Les données ont été collectées à l'aide d'une version modifiée du questionnaire administré par un enquêteur, l'outil d'enquête Surgeons OverSeas Assessment of Surgical Need (SOSAS). Les données ont été analysées à l'aide de l'outil analytique REDCap. RÉSULTATS: Huit cent cinquante-six ménages ont été enquêtés, ce qui a donné 1 992 adultes. Quatre-vingt-quinze adultes se sont plaints de conditions chirurgicales, donnant un taux de prévalence de 5 %. La grande majorité des conditions rapportées étaient des déformations acquises (n=94) tandis qu'une seule déformation congénitale a été signalée. Les autres incluaient des nodules mammaires, des gonflements antérieurs du cou et des gonflements inguinaux. CONCLUSION: Les plaintes chirurgicales les plus courantes dans notre cadre parmi les adultes étaient des conditions acquises des extrémités et des plaies ouvertes/ulcères. Avec une population estimée à 90 millions d'adultes et environ 1 200 chirurgiens orthopédiques et généralistes respectivement, le ratio chirurgien-population affectée est de 1:10,000. Il y a un grand écart à combler en termes de développement de la main-d'œuvre chirurgicale. MOTS CLÉS: Prévalence, Charge de morbidité, Chirurgie, Plaies.


Asunto(s)
Población Rural , Población Urbana , Humanos , Nigeria/epidemiología , Estudios Transversales , Adulto , Femenino , Masculino , Población Rural/estadística & datos numéricos , Persona de Mediana Edad , Población Urbana/estadística & datos numéricos , Adulto Joven , Prevalencia , Encuestas y Cuestionarios , Adolescente , Procedimientos Quirúrgicos Operativos/estadística & datos numéricos , Necesidades y Demandas de Servicios de Salud , Anciano , Evaluación de Necesidades
10.
Reprod Sci ; 2024 Jun 21.
Artículo en Inglés | MEDLINE | ID: mdl-38907126

RESUMEN

Pelvic organ prolapse (POP), a downward descent of the vagina and/or uterus through the vaginal canal, is a prevalent condition affecting up to 40% of women. Several risk factors of POP have been identified, including childbirth, connective tissue defects, and chronic intra-abdominal pressure; however, the underlying etiologies of POP development are not fully understood, leading to a high burden on patients and the healthcare systems. The uterosacral ligaments are key support structures of the uterus and upper vagina. Our previous work describes observed histopathological changes in uterosacral ligament (USL) tissue and demonstrates the presence of neutrophils in a subgroup of POP individuals. This presence of neutrophils prompted an examination for the presence of a broader spectrum of inflammatory cell types in the USL. Immunohistochemical staining was performed to identify neutrophils, lymphocytes, macrophages, and mast cells outside of the vasculature. All 4 inflammatory cell types were increased in the POP-HQ system-defined POP-Inflammatory (POP-I) phenotype USL tissue relative to the USL tissues of control or other POP-HQ phenotypes. Focal T-lymphocyte and macrophage co-accumulations were observed in the arterial walls from some patients of the POP-vascular (POP-V) phenotype suggesting previous arterial injury. In addition, 1 control and 2 POP-V subjects' USLs contained arterial wall foamy macrophages, evidence of atherosclerosis. These findings further support a complex etiology for POP and indicate that personalized approaches to preventing and treating the condition may be warranted.

11.
Brain Behav Evol ; 99(3): 171-183, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38857586

RESUMEN

INTRODUCTION: Social experience early in life appears to be necessary for the development of species-typical behavior. Although isolation during critical periods of maturation has been shown to impact behavior by altering gene expression and brain development in invertebrates and vertebrates, workers of some ant species appear resilient to social deprivation and other neurobiological challenges that occur during senescence or due to loss of sensory input. It is unclear if and to what degree neuroanatomy, neurochemistry, and behavior will show deficiencies if social experience in the early adult life of worker ants is compromised. METHODS: We reared newly eclosed adult workers of Camponotus floridanus under conditions of social isolation for 2-53 days, quantified brain compartment volumes, recorded biogenic amine levels in individual brains, and evaluated movement and behavioral performance to compare the neuroanatomy, neurochemistry, brood-care behavior, and foraging (predatory behavior) of isolated workers with that of workers experiencing natural social contact after adult eclosion. RESULTS: We found that the volume of the antennal lobe, which processes olfactory inputs, was significantly reduced in workers isolated for an average of 40 days, whereas the size of the mushroom bodies, centers of higher-order sensory processing, increased after eclosion and was not significantly different from controls. Titers of the neuromodulators serotonin, dopamine, and octopamine remained stable and were not significantly different in isolation treatments and controls. Brood care, predation, and overall movement were reduced in workers lacking social contact early in life. CONCLUSION: These results suggest that the behavioral development of isolated workers of C. floridanus is specifically impacted by a reduction in the size of the antennal lobe. Task performance and locomotor ability therefore appear to be sensitive to a loss of social contact through a reduction of olfactory processing ability rather than change in the size of the mushroom bodies, which serve important functions in learning and memory, or the central complex, which controls movement.


Asunto(s)
Hormigas , Encéfalo , Aislamiento Social , Animales , Hormigas/fisiología , Hormigas/anatomía & histología , Encéfalo/metabolismo , Encéfalo/anatomía & histología , Conducta Social , Conducta Animal/fisiología , Cuerpos Pedunculados/metabolismo , Cuerpos Pedunculados/anatomía & histología , Aminas Biogénicas/metabolismo , Dopamina/metabolismo
12.
Front Cell Dev Biol ; 12: 1382960, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38863942

RESUMEN

Introduction: Vertebrate body axis formation initiates during gastrulation and continues within the tail bud at the posterior end of the embryo. Major structures in the trunk are paired somites, which generate the musculoskeletal system, the spinal cord-forming part of the central nervous system, and the notochord, with important patterning functions. The specification of these different cell lineages by key signalling pathways and transcription factors is essential, however, a global map of cell types and expressed genes in the avian trunk is missing. Methods: Here we use high-throughput sequencing approaches to generate a molecular map of the emerging trunk and tailbud in the chick embryo. Results and Discussion: Single cell RNA-sequencing (scRNA-seq) identifies discrete cell lineages including somites, neural tube, neural crest, lateral plate mesoderm, ectoderm, endothelial and blood progenitors. In addition, RNA-seq of sequential tissue sections (RNA-tomography) provides a spatially resolved, genome-wide expression dataset for the avian tailbud and emerging body, comparable to other model systems. Combining the single cell and RNA-tomography datasets, we identify spatially restricted genes, focusing on somites and early myoblasts. Thus, this high-resolution transcriptome map incorporating cell types in the embryonic trunk can expose molecular pathways involved in body axis development.

13.
Artículo en Inglés | MEDLINE | ID: mdl-38595271

RESUMEN

INTRODUCTION: Tourniquet (TQ) use for hemorrhage control is a core skill for many law enforcement officers (LEO) and all emergency medical services (EMS) providers. However, LEO TQ training is not as intensive as EMS. Overuse of TQ can result in over triage. We hypothesize that LEO are more liberal than EMS with TQ placement. METHODS: A seven-year retrospective, single center study of adult patients who had a TQ placed in the field was conducted. Data were stratified by provider who placed the TQ. Patient demographics, body location where the TQ was placed, hospital location where the TQ was removed, incidence of recurrent bleeding and need for operative control of bleeding, and name of injured vessel were recorded. Data were analyzed using student t-test and Chi-square tests. RESULTS: 192 patients had 197 TQ placed (LEO 77 (40%) and EMS 120 (63%). Most TQ were placed on the thigh. There was no difference in body mass index but the EMS cohort had a higher injury severity score (9.4 v 6.5, p = 0.03) and extremity abbreviated injury severity score (2.4 v 1.9, p = 0.007). LEO placed TQ were more commonly removed in the trauma bay (83% v 73%, p = 0.03). EMS placed TQ were more likely to require operative control of bleeding (23% v 6%, p = 0.003). There were no complications related to TQ use in either arm. CONCLUSIONS: LEO are more likely than EMS to place tourniquets without injury to a named vessel or the presence of severe bleeding. LEO need better training to determine when a TQ is needed. EMS should be allowed to remove TQ if appropriate. Studies on the impact of over triage based on TQ use are needed. LEVEL OF EVIDENCE: Therapeutic/Care Management, Level III.

14.
J Pediatr Urol ; 20(4): 726.e1-726.e7, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38653666

RESUMEN

BACKGROUND: Urinary drainage for posterior urethral valves can be achieved with valve ablation (VA) or diversion by vesicostomy (VES) or cutaneous ureterostomy (CU). The effect of these interventions on long-term bladder function remains debated, and voiding symptomatology after VES or CU reversal has been poorly characterized. OBJECTIVE: The objective of this study was to examine the prevalence and scope of physician treatment patterns as a surrogate for retention or incontinence symptomatology among PUV patients undergoing primary VA or diversion by VES/CU and determine rates of progression to augmentation. STUDY DESIGN: This is a single-institution retrospective cohort study. Retention Scores (R) were calculated 1 point for: retention behavior (double/timed void), alpha-blocker, intermittent catheterization, or overnight indwelling catheter. Incontinence Scores (I) were calculated 1 point for: incontinence behavior (double/timed void), oral medication, or botulinum toxin. Patients with R score above 3 or I score above 2 were deemed to have severe retention or incontinence symptomatology respectively. End stage bladder (ESB) was defined as need for bladder augmentation. RESULTS: We identified 76 patients between 5 and 40 years old with median follow-up of 14.6 [5.0-40.4) years. There was no difference in the rates of severe retention or incontinence treatment pattern scoring between VA versus VES/CU (Figure). Rates of achieving R(1) status are similar between VA and VES/CU groups, though age of reaching R(1) was younger for those with VES/CU (4.8 years) compared to VA (6.6 years). There was no significant difference in rate of ESB by intervention category VA (9.4%) versus VES/CU (17.4%; p = 0.323). DISCUSSION: Treatment of retention symptomatology was more common than treatment of incontinence symptomatology regardless of primary management, VA or VES/CU. This study also indicates that VES/CU patients were just as responsive as VA patients to conservative treatments (behavioral changes, pharmacotherapy) for any type of bladder symptomatology as the progression to treatment of severe symptomatology and ESB were similar between cohorts. In this cohort, bladder outcomes were not associated with type of urinary diversion (VA or VES/CU). CONCLUSION: Long term bladder outcomes for valve patients demonstrated similar treatment patterns and progression to end-stage bladder regardless of diversion status. Patients went on to ESB approximately 4.4 years after diagnosis at similar rates between groups.


Asunto(s)
Uretra , Humanos , Estudios Retrospectivos , Masculino , Niño , Uretra/anomalías , Uretra/cirugía , Adolescente , Preescolar , Adulto , Adulto Joven , Resultado del Tratamiento , Factores de Tiempo , Pautas de la Práctica en Medicina/estadística & datos numéricos , Estudios de Seguimiento , Vejiga Urinaria/cirugía , Femenino , Estudios de Cohortes , Derivación Urinaria/métodos
15.
Meat Sci ; 214: 109518, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38677055

RESUMEN

This is the first UK genome wide association study investigating potential links between Video Image Analysis (VIA) carcass traits and molecular polymorphisms in crossbred sheep. Phenotypic and genotypic data were collected from two crossbred lamb populations: Texel x Scotch Mule (TxSM, n = 2330) and Texel x Lleyn (TxL, n = 3816). Traits measured included live weights at birth, eight weeks and weaning (∼15 weeks). VIA-predicted traits included total weights and weights of fat, muscle and bone in the whole carcass and primal (hind leg, saddle, shoulder) regions. Within-breed heritabilities estimated for the VIA traits ranged from 0.01 to 0.70, indicating potential for inclusion of some traits in breeding programmes. The two crossbred populations differed in SNPs associated with different traits. Two SNPs on chromosomes two (s74618.1) and eight (s68536.1), respectively, reached genome-wise significance for TxSM, explaining <1% of trait variance, for whole carcass fat and muscle weights, hind leg and saddle fat weights and shoulder bone weights. For TxL, four SNPs reached genome-wise significance, on chromosome two for hind leg muscle weight (OAR2_117,959,202 and OAR2_11804335), on chromosome 10 for whole carcass bone weight (OAR19_8,995,957.1), and on chromosome 19 for weaning weight (s40847.1), each explaining <1% of trait genetic variation. Differences in apparent genetic control of carcass traits may be influenced by the lambs' cross-breed, but also by management decisions affecting environmental variance and trait definitions, which should be understood in order to define protocols for incorporation of carcass traits into (cross)breeding programmes. IMPLICATIONS: Combining VIA-measured carcass traits with conventional production traits in a breeding programme could potentially improve the production and product quality of meat sheep. Phenotypes for VIA traits could be collected relatively easily if VIA machines were present at all abattoir sites. The current study and future Genome Wide Association Studies may help to identify potentially informative molecular markers, that explain large proportions of the genetic variance observed in VIA-measured carcass traits. Including this information in the estimation of breeding values could increase the accuracy of prediction, increasing the potential rate of genetic improvement for product quality. This study confirms the polygenic architecture of the investigated carcass traits, with a small number of molecular markers that each explain a small amount of genetic variation. Further studies across breed types are recommended to further test and validate molecular markers for traits related to lamb carcass quality, as measured by video image analysis.


Asunto(s)
Cruzamiento , Estudio de Asociación del Genoma Completo , Músculo Esquelético , Fenotipo , Polimorfismo de Nucleótido Simple , Carne Roja , Oveja Doméstica , Animales , Carne Roja/análisis , Oveja Doméstica/genética , Masculino , Tejido Adiposo , Femenino , Genotipo , Composición Corporal/genética , Peso Corporal/genética , Procesamiento de Imagen Asistido por Computador/métodos , Grabación en Video
16.
Clin Immunol ; 263: 110214, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38604255

RESUMEN

OBJECTIVE: To derive childhood-onset SLE (cSLE) specific remission definitions for future treat-to-target (T2T) trials, observational studies, and clinical practice. METHODS: The cSLE International T2T Task Force conducted Delphi surveys exploring paediatric perspectives on adult-onset SLE remission targets. A modified nominal group technique was used to discuss, refine, and agree on the cSLE remission target criteria. RESULTS: The Task Force proposed two definitions of remission: 'cSLE clinical remission on steroids (cCR)' and 'cSLE clinical remission off steroids (cCR-0)'. The common criteria are: (1) Clinical-SLEDAI-2 K = 0; (2) PGA score < 0.5 (0-3 scale); (4) stable antimalarials, immunosuppressive, and biologic therapy (changes due to side-effects, adherence, weight, or when building up to target dose allowed). Criterion (3) in cCR is the prednisolone dose ≤0.1 mg/kg/day (maximum 5 mg/day), whereas in cCR-0 it is zero. CONCLUSIONS: cSLE definitions of remission have been proposed, maintaining sufficient alignment with the adult-SLE definition to facilitate life-course research.


Asunto(s)
Consenso , Lupus Eritematoso Sistémico , Inducción de Remisión , Humanos , Lupus Eritematoso Sistémico/tratamiento farmacológico , Lupus Eritematoso Sistémico/diagnóstico , Niño , Inmunosupresores/uso terapéutico , Edad de Inicio , Técnica Delphi , Comités Consultivos
17.
Cancer Control ; 31: 10732748241244678, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38563112

RESUMEN

INTRODUCTION: Women living with HIV (WLHIV) have higher prevalence and persistence rates of high-risk human papillomavirus (hr-HPV) infection with a six-fold increased risk of cervical cancer. Thus, more frequent screening is recommended for WLHIV. OBJECTIVES: This retrospective descriptive cross-sectional study was conducted to investigate and compare the prevalence of hr-HPV infection and abnormal findings on mobile colposcopy in two cohorts of WLHIV following cervical screening in rural and urban settings in Ghana. METHODS: Through the mPharma 10 000 Women Initiative, WLHIV were screened via concurrent hr-HPV DNA testing (MA-6000; Sansure Biotech Inc., Hunan, China) and visual inspection (Enhanced Visual Assessment [EVA] mobile colposcope; MobileODT, Tel Aviv, Israel) by trained nurses. The women were screened while undergoing routine outpatient reviews at HIV clinics held at the Catholic Hospital, Battor (rural setting) and Tema General Hospital (urban setting), both in Ghana. RESULTS: Two-hundred and fifty-eight WLHIV were included in the analysis (rural, n = 132; urban, n = 126). The two groups were comparable in terms of age, time since HIV diagnosis, and duration of treatment for HIV. The hr-HPV prevalence rates were 53.7% (95% CI, 45.3-62.3) and 48.4% (95% CI, 39.7-57.1) among WLHIV screened in the rural vs urban settings (p-value = .388). Abnormal colposcopy findings were found in 8.5% (95% CI, 5.1-11.9) of the WLHIV, with no significant difference in detection rates between the two settings (p-value = .221). Three (13.6%) of 22 women who showed abnormal colposcopic findings underwent loop electrosurgical excision procedure (LEEP), leaving 19/22 women from both rural and urban areas with pending treatment/follow-up results, which demonstrates the difficulty faced in reaching early diagnosis and treatment, regardless of their area of residence. Histopathology following LEEP revealed CIN III in 2 WLHIV (urban setting, both hr-HPV negative) and CIN I in 1 woman in the rural setting (hr-HPV positive). CONCLUSIONS: There is a high prevalence of hr-HPV among WLHIV in both rural and urban settings in this study in Ghana. Concurrent HPV DNA testing with a visual inspection method (colposcopy/VIA) reduces loss to follow-up compared to performing HPV DNA testing as a standalone test and recalling hr-HPV positive women for follow up with a visual inspection method. Concurrent HPV DNA testing and a visual inspection method may also pick up precancerous cervical lesions that are hr-HPV negative and may be missed if HPV DNA testing is performed alone.


Asunto(s)
Infecciones por VIH , Infecciones por Papillomavirus , Lesiones Precancerosas , Displasia del Cuello del Útero , Neoplasias del Cuello Uterino , Embarazo , Femenino , Humanos , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/epidemiología , Neoplasias del Cuello Uterino/patología , Colposcopía , Detección Precoz del Cáncer/métodos , Estudios Transversales , Estudios Retrospectivos , Ghana , Papillomaviridae/genética , Displasia del Cuello del Útero/diagnóstico , Displasia del Cuello del Útero/epidemiología , Tamizaje Masivo/métodos , Lesiones Precancerosas/diagnóstico , Lesiones Precancerosas/epidemiología , Infecciones por VIH/diagnóstico , Infecciones por VIH/epidemiología
18.
Chron Respir Dis ; 21: 14799731241238435, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38553857

RESUMEN

OBJECTIVES: This study aimed to determine the feasibility of a group-based pilot programme of low-to-moderate physical activity training, education and social activities, by investigating acceptability, practicality, implementation and efficacy testing. We offer suggestions on programme adaptions for future study. METHODS: People with a range of chronic respiratory diseases were invited to participate in a pilot 12 week group activity programme. Activities included outdoor walking, tai-chi, education and a range of social activities. Acceptability was determined by participant experiences determined during interviews. Practicality was determined by programme and outcome measure completion, cost and adverse events. Implementation was determined according to whether the programme ran as planned. Efficacy was determined by statistical analyses of outcomes including hand grip strength, timed up and go test, COPD Helplessness Index, COPD Assessment Test, and measures of physical activity via accelerometry. RESULTS: Thematic analysis indicated that the "BreatheHappy" programme was acceptable. Seven of nine participants completed eight out of 10 sessions and the majority completed all outcome measures. "BreatheHappy" was therefore considered practical. The programme was not implemented as planned, with only 10 sessions running rather than the 12 intended. There was a significant increase in daily step counts (MD: 1284 95% CI: 240-2329 p: 0.024 effect size: 0.988), stepping time (MD: 16 min 95% CI: 5-27 min p: 0.011 effect size: 1.36) and daily minutes completing light physical activity (MD: 23 95% CI: 6-38 p: 0.006 effect size: 1.6). However, time spent sitting for ≥30 min but ≤60 min significantly increased (MD: 26 95% CI: 0.2-52 min p: 0.049 effect size: 0.931), showing signs of efficacy and changing physical activity behaviour patterns. DISCUSSION: A 10-week programme of low-moderate physical activity training, education and social activities shows signs of feasibility for future research. Suggested adaptions for future study include using physical activity measures such as daily step count or light physical activity for a primary outcome, and mental health and social health related outcome measures relatable to participant's beneficial experiences of the programme. Recruitment in future studies will try and reach both those less socially active and possibly those who have completed pulmonary rehabilitation (PR). Venues should be close to efficient transport links whilst different frequencies and durations of programme delivery should be trialled. Adequate funding should be provided for both staff running the programme and blinded research staff for outcome measurement.


Asunto(s)
Fuerza de la Mano , Enfermedad Pulmonar Obstructiva Crónica , Humanos , Estudios de Factibilidad , Equilibrio Postural , Estudios de Tiempo y Movimiento , Enfermedad Pulmonar Obstructiva Crónica/rehabilitación , Calidad de Vida
19.
Nat Commun ; 15(1): 1049, 2024 Feb 05.
Artículo en Inglés | MEDLINE | ID: mdl-38316803

RESUMEN

Expanded international trade and globalised production networks are increasing the environmental and social impacts in middle-income countries (GNI per capita $1,136-$13,845). High-income countries (>$13,845) are seeking to mitigate the negative impacts of domestic consumption by imposing new sustainability regulations on global supply chains. Recent evidence suggests that these regulations are broadly supported across high-income countries. However, it remains unclear whether citizens of middle-income countries support aligning domestic sustainability regulations with the measures developed by high-income countries. Concerns about economic competitiveness and foreign imposition could increase public resistance toward such alignment. Alternatively, desires for continued market access in high-income countries and aspirations for strengthening local environmental and labour regulations could foster support for alignment. Based on survey-embedded experiments in the three largest democratic non-OECD economies (Brazil, India, Indonesia), we find surprisingly strong support for domestic-based measures that are aligned with emerging global supply chain sustainability regulations. Our findings suggest that support is largely driven by positive impact expectations, where the future benefits of alignment are perceived as outweighing concerns about increased costs. These results bode well for initiatives to install stricter sustainability regulations for global supply chains that are acceptable not only in high-income economies but also in non-OECD countries.

20.
Animal ; 18(2): 101065, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38237476

RESUMEN

Production animals are increasingly exposed to a wide variety of disturbances that can compromise their productivity, health and well-being. As a result, there is a growing need to be able to select animals that are more resilient to environmental disturbances. Fibre diameter variation measured along a wool staple is expected to contain information about how resilient sheep are to the disturbances of their internal and external environment. This study aimed to develop potential resilience indicators from fibre diameter variation, estimate their genetic parameters and assess whether these traits are genetically correlated across three age stages. The study used 6 140 Merino sheep from the Sheep Cooperative Research Centre Information Nucleus Flocks recorded at yearling, 2 years old, and adult ages. Eight potential traits were defined based on theory, literature and exploratory analysis, which were suggested to capture the animal's ability to resist, respond and recover from potential disturbances. Genetic evaluation of the traits was conducted using pedigree-based animal models. The traits were shown to be low to moderately heritable (0.01-0.33) when examined at each of the three age stages. The potential indicators were generally well correlated with one another within age stages. Further, the genetic correlation between the same trait measured at different age stages was moderate to high between yearling and 2 years old (0.35-0.94) and between 2 years old and adults (0.18-0.70), while slightly lower between yearling and adult estimates (0.09-0.62). These results suggest that selection for resilience indicators from fibre diameter is possible; however, further studies are warranted to refine the trait definitions and validate these indicators against other measures of health, fitness and productive performance.


Asunto(s)
Resiliencia Psicológica , Lana , Ovinos/genética , Animales , Fenotipo , Oveja Doméstica/genética , Variación Genética
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