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Smith, Lee, Nicola Veronese, Guillermo F. López-Sánchez, Lin Yang, Damiano Pizzol, Laurie T. Butler, Yvonne Barnett, et al. "Active Travel and Mild Cognitive Impairment among Older Adults from Low- and Middle-Income Countries." Journal of Clinical Medicine 10, no. 6 (March 17, 2021): 1243. http://dx.doi.org/10.3390/jcm10061243.
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Active travel may be an easily achievable form of physical activity for older people especially in low- and middle-income countries (LMICs), but there are currently no studies on how this form of physical activity is associated with a preclinical state of dementia known as mild cognitive impairment (MCI). Therefore, we aimed to investigate the association between active travel and MCI among adults aged ≥50 years from six LMICs. Cross-sectional, community-based data from the World Health Organization’s Study on Global Ageing and Adult Health were analyzed. The definition of MCI was based on the National Institute on Ageing-Alzheimer’s Association criteria. Active travel (minutes/week) was assessed with questions of the Global Physical Activity Questionnaire (GPAQ) and presented in tertiles. Multivariable logistic regression analysis was conducted to assess the association between active travel and MCI. Data on 32715 people aged ≥50 years (mean age 62.4 years; 52.1% females) were analyzed. Compared to the highest tertile of active travel, the lowest tertile was associated with 1.33 (95%CI = 1.14–1.54) times higher odds for MCI overall. This association was particularly pronounced among those aged ≥65 years (OR = 1.70; 95%CI = 1.32–2.19) but active travel was not associated with MCI among those aged 50–64 years. In conclusion, low levels of active travel were associated with a significantly higher odds of MCI in adults aged ≥65 years in LMICs. Promoting active travel among people of this age group in LMICs via tailored interventions and/or country-wide infrastructure investment to provide a safe environment for active travel may lead to a reduction in MCI and subsequent dementia.
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Djambas Khayat, Claudia, Johnny N. Mahlangu, Ross I. Baker, Cindy A. Leissinger, Elena Santagostino, Debra M. Bensen-Kennedy, Katie St. Ledger, Alex Veldman, and Ingrid Pabinger. "Rviii-Singlechain in Surgical Prophylaxis: Efficacy and Safety of Continuous and Bolus Infusion." Blood 126, no. 23 (December 3, 2015): 3525. http://dx.doi.org/10.1182/blood.v126.23.3525.3525.
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Abstract Background: rVIII-SingleChain, a novel recombinant Factor VIII, has been designed as a B-domain truncated construct with a covalent bond between the heavy and light chain, aiming for a higher binding affinity to von Willebrand Factor. rVIII-SingleChain has a lower clearance, longer half-life and larger area under the curve compared to octocog alfa (Advate®). This sub-study of the AFFINITY program investigated the safety and efficacy of rVIII-SingleChain to control hemostasis in adult and adolescent patients (12 - 65 years of age) with severe Hemophilia A undergoing major surgery. rVIII-SingleChain was used either as continuous infusion or as a bolus injection. Methods: The study was approved by the relevant ethics committees and national authorities and conducted according to GCP and the Declaration of Helsinki. 13 patients underwent a total of 16 major surgical procedures (a surgical procedure that required general, spinal or regional anesthesia). Dosing was guided by the WFH recommendations. In 8 patients, rVIII-SingleChain was used as continuous infusion and in 8 patients rVIII-SingleChain was used as a bolus injection. Results: The following procedures were performed using continuous infusion: knee replacement (5), cholecystectomy, lengthening of the achilles tendon combined with surgical correction of the right toes, and open reduction and internal fixation of right ankle fracture. Furthermore, circumcision (3), extraction of wisdom teeth, abdominal hernia repair, elbow replacement, ankle arthroplasty, and hardware removal of the right ankle were performed after administering a bolus injection of rVIII-SingleChain. In the 8 procedures that were covered by bolus injection rVIII-SingleChain median pre- and intraoperative consumption was 79.2 IU/kg, and in the 8 procedures that were covered by continuous infusion, rVIII-SingleChain median pre- and intraoperative consumption was 92.5 IU/kg. Investigators rated the efficacy of rVIII-SingleChain during surgery as excellent (defined as hemostasis not clinically significant different from normal) in all cases but one (knee replacement under continuous infusion), in which it was rated as good (defined as hemostasis normal or mildly abnormal in terms of quantity and/or quality e.g., slight oozing). After the procedure, patients returned to routine treatment after a median of 9 days. No related AEs or SAEs were observed during the surgery period. Conclusion: rVIII-SingleChain provides very effective and safe control of hemostasis during a wide range of surgical procedures when dosed either by continuous infusion or by bolus injection. Consumption of factor on the day of surgery seems to be comparable in both treatment regimens. Disclosures Mahlangu: NovoNordisk: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Bayer: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Biogen: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; CSL Behring: Research Funding; Biotest: Honoraria, Membership on an entity's Board of Directors or advisory committees; Roche: Honoraria, Membership on an entity's Board of Directors or advisory committees. Baker:Daiichi Sankyo: Research Funding; CSL Behring: Research Funding; Portola Pharmaceuticals: Research Funding; Astellas: Research Funding; Bayer: Membership on an entity's Board of Directors or advisory committees, Research Funding; Boehringer Ingelheim: conference travel support, Membership on an entity's Board of Directors or advisory committees, Research Funding; Biogen Idec: Membership on an entity's Board of Directors or advisory committees, Research Funding; Baxter Healthcare: Membership on an entity's Board of Directors or advisory committees, Other: conference travel support , Research Funding; Pfizer: Membership on an entity's Board of Directors or advisory committees, Research Funding; Amgen: Membership on an entity's Board of Directors or advisory committees, Other: conference travel support; Alexion Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees, Other: conference travel support; Bristol-Myers Squibb: Membership on an entity's Board of Directors or advisory committees, Research Funding; Novo Nordisk: Other: conference travel support. Leissinger:Biogen: Research Funding; Pfizer: Membership on an entity's Board of Directors or advisory committees; Roche: Membership on an entity's Board of Directors or advisory committees, Research Funding; CSL Behring: Membership on an entity's Board of Directors or advisory committees, Research Funding; Kedrion: Membership on an entity's Board of Directors or advisory committees; Baxter: Membership on an entity's Board of Directors or advisory committees, Research Funding; Novo Nordisk: Membership on an entity's Board of Directors or advisory committees, Research Funding; Bayer: Membership on an entity's Board of Directors or advisory committees, Research Funding. Santagostino:Pfizer: Research Funding; Novo Nordisk: Membership on an entity's Board of Directors or advisory committees; Baxter: Membership on an entity's Board of Directors or advisory committees; CSL Behring: Membership on an entity's Board of Directors or advisory committees, Research Funding; Grifols: Membership on an entity's Board of Directors or advisory committees; Bayer: Membership on an entity's Board of Directors or advisory committees; Biotest: Speakers Bureau; Octapharma: Speakers Bureau; Kedrion: Speakers Bureau; Biogen/Sobi: Membership on an entity's Board of Directors or advisory committees. Bensen-Kennedy:CSL Behring: Employment. St. Ledger:CSL Behring: Employment. Veldman:CSL Behring: Employment. Pabinger:Boehringer Ingelheim: Membership on an entity's Board of Directors or advisory committees; CSL Behring: Membership on an entity's Board of Directors or advisory committees, Other: Travel support, Research Funding; Pfizer: Membership on an entity's Board of Directors or advisory committees; Amgen: Membership on an entity's Board of Directors or advisory committees; Baxter: Membership on an entity's Board of Directors or advisory committees; GSK: Membership on an entity's Board of Directors or advisory committees; Bayer: Membership on an entity's Board of Directors or advisory committees.
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Cohen, I. Glenn. "Transplant Tourism: The Ethics and Regulation of International Markets for Organs." Journal of Law, Medicine & Ethics 41, no. 1 (2013): 269–85. http://dx.doi.org/10.1111/jlme.12018.
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“Medical Tourism” is the travel of residents of one country to another country for treatment. In this article I focus on travel abroad to purchase organs for transplant, what I will call “Transplant Tourism.” With the exception of Iran, organ sale is illegal across the globe, but many destination countries have thriving black markets, either due to their willful failure to police the practice or more good faith lack of resources to detect it. I focus on the sale of kidneys, the most common subject of transplant tourism, though much of what I say could be applied to other organs as well. Part I briefly reviews some data on sellers, recipients, and brokers. Part II discusses the bioethical issues posed by the trade, and Part III focuses on potential regulation to deal with these issues.
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Shura, Robin, Elle Rochford, and Brian K. Gran. "Children for sale? The blurred boundary between intercountry adoption and sale of children in the United States." International Journal of Sociology and Social Policy 36, no. 5/6 (June 13, 2016): 319–34. http://dx.doi.org/10.1108/ijssp-03-2015-0034.
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Purpose – Intercountry adoptions (hereafter ICAs) in the USA are a form of sale of children. According to international policy, sale of children is an illicit social practice that involves improper financial gains by at least one party. Sale of children is a threat to legitimate ICA. The purpose of this paper is to analyse the policy and practice of ICAs in the USA, including pricing arrangements, demonstrate that US ICAs, which can have humanitarian aims and be legitimate forms of family development, comprise sale of children. Design/methodology/approach – Internet searches and e-mail inquiries were used to obtain ICA cost data for a randomised sample of 10 per cent of the agencies in the USA that facilitate ICAs. Findings – Cost information was obtained from only 25 per cent of the sample, suggesting lack of transparency in and available information about monetary costs of US ICAs. A range of US$12,000 to $40,000 suggests that US ICAs are expensive and costs vary. Large, undisclosed fees in the form of “required donations”, agency fees, and extensive foreign travel requirements imply third party economic gains are made through US ICA transactions. Practical implications – US ICA agencies should disclose costs and employ transparent practices. US policies regulating ICAs should be clarified and strengthened. The US Government should ratify, implement, and enforce major children’s rights international policy standards. Social implications – International demand for adopted children may encourage child trafficking, child laundering, and kidnapping for profit (see Smolin, 2005), putting children, adoptive families, and birth communities at risk of breaches of basic human rights. Originality/value – No study has offered systematic analysis of monetary costs of US ICAs and linked this analysis to policy and legitimacy of social practices.
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Kuang, Lishan, Yizhuo Liu, Wei Wei, Xueqing Song, Xiaoqian Li, Qiqi Liu, Weimin Hong, et al. "Non-prescription sale of antibiotics and service quality in community pharmacies in Guangzhou, China: A simulated client method." PLOS ONE 15, no. 12 (December 10, 2020): e0243555. http://dx.doi.org/10.1371/journal.pone.0243555.
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Objective To measure the situation of the non-prescription sale of antibiotics and the service quality of community pharmacies in Guangzhou, China. Methods A simulated client method was conducted to estimate the non-prescription sale of antibiotics and service quality based on scenarios about adult acute upper respiratory tract infection in 2019. A total of 595 community pharmacies from 11 districts were investigated in Guangzhou, China. We used binary logistic regression to evaluate the factors associated with the non-prescription sale of antibiotics. Results The proportion of non-prescription dispensing of antibiotics was 63.1% in Guangzhou, China, with a higher incidence of antibiotic dispensing without prescription in outer districts (69.3%). Cephalosporin (44.1%) and Amoxicillin (39.0%) were sold more often than other antibiotics. Chain pharmacies had better performance on the prescription sale of antibiotics and service quality. Traditional Chinese medicine was commonly recommended by pharmacy staff. Conclusion Since the non-prescription sale of antibiotics is prevalent in Guangzhou, effective solutions should be determined. Strengthened public awareness and regulatory system innovation are needed.
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Robertson, Christopher T. "Vaccines and Airline Travel." American Journal of Law & Medicine 42, no. 2-3 (May 2016): 543–71. http://dx.doi.org/10.1177/0098858816658279.
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This Article explores two ways in which airline travel is an important vector for the spread of infectious disease, and argues that airlines have market-based and liability-based reasons to require that passengers be vaccinated. Going further, the Article explores whether the federal government has the legal and constitutional authority—especially under the Commerce Clause—to encourage or mandate that airlines implement such a vaccine screen. By disrupting the spread of disease at key network nodes where individuals interact and then connect with other geographic regions, and by creating another incentive for adult vaccination, an airline vaccine screen could be an effective and legally viable tool for the protection of public health.
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Petrunov, Georgi. "Human Trafficking in Eastern Europe." ANNALS of the American Academy of Political and Social Science 653, no. 1 (March 28, 2014): 162–82. http://dx.doi.org/10.1177/0002716214521556.
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Eastern Europe is among the major sources of migrants who travel for work to other European nations. In this research, in-depth interviews and analysis of legal cases of migration in Bulgaria reveal that the typical kinds of human trafficking in the region are sexual exploitation, labor exploitation, forced servitude, and trafficking of pregnant women for the sale of their babies. For each type, I examine victim profiles, recruitment strategies, transportation, and the types of control and exploitation that traffickers use. Comparisons are drawn between the Bulgarian findings and patterns in other Eastern European nations.
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Ericsson, Charles D. "Travel Medicine: Key to Improved Adult Vaccination against Hepatitis A and B." Journal of Travel Medicine 8, s1 (January 2001): s1—s2. http://dx.doi.org/10.1111/j.1708-8305.2001.tb00537.x.
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Acheampong, Ransford A. "Cycling for Sustainable Transportation in Urban Ghana: Exploring Attitudes and Perceptions among Adults with Different Cycling Experience." Journal of Sustainable Development 9, no. 1 (January 26, 2016): 110. http://dx.doi.org/10.5539/jsd.v9n1p110.
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<p>Attitudinal and perceptual factors are important determinants of bicycle use as a mode of transportation. Understanding how attitudes and perceptions vary across different population is critical for successful cycling promotion interventions. Drawing on research from the context of an African city, this paper examines attitudes and perceptions about utility cycling in the general population, and determines if there are differences in how males and females who have different cycling experience perceive cycling for commuting purposes. Using non-parametric test, the study found that attitudes and perceptions regarding the environmental, financial, exercise and potential health benefits of cycling for transportation were very positive generally, and slightly stronger in females who had never cycled before than in males in the same group. Cycling was also not perceived as the most comfortable, safe, easy, convenient and flexible mode of transportation suitable for long distance travel among the majority of the respondents. These perceptions and attitudes were pronounced in females in the sub-group of respondents who had never cycled before and those who cycled previously than in males in the same groups. Among frequent cyclists, males perceived cycling for commute as a less tiring activity than females. Moreover, cycling’s public image as a less prestigious mode of transport that could not be taken to important social events was prevalent among the respondents, although this perception was found to be stronger in males than in females who had not cycled before. The findings could inform tailored cycling promotion programmes within the general population and across specific groups.</p>
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Wythes, JR, RK Kaus, and GA Newman. "Bruising in beef cattle slaughtered at an abattoir in southern Queensland." Australian Journal of Experimental Agriculture 25, no. 4 (1985): 727. http://dx.doi.org/10.1071/ea9850727.
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The level of bruising and its distribution on the carcass was assessed for 35 085 cattle at an abattoir in southern Queensland. Using the Australian Carcase Bruise Scoring System, the average bruise score was 8.4 points (equivalent to 1.1 kg bruise trim) per carcass, with 61%of bruising on the hindquarters. Forty-two carcasses (0.12%) were condemned because of bruising. There were significant ( P< 0.01) differences between slaughter-lots due to horn status (mixed horn > hornless group), class of animal (mixed sex and cow > steer > bull groups), breed (Zebu crossbred > British breed groups), mode of travel (road plus rail > road > road plus walk), and individual saleyard. There were no differences due to method of sale (direct to abattoir v. via saleyard), road transport operators, road distance travelled (<50 to > 500 km), or due to unloading cattle from trucks to dip for ticks. The results indicate that animal factors, such as horn status and class of animal, may be more important sources of bruising than transportation (at least by major transport operators) and method of sale. Future efforts to reduce the level of bruising depend on all meat processors paying lower prices for bruised carcasses and publicly proclaiming these differential prices.
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Oba, Patrícia M., Meredith Carroll, Tammi Epp, Christine Warzecha, Jessica L. Varney, Jason W. Fowler, Craig N. Coon, and Kelly S. Swanson. "88 Effects of Saccharomyces cerevisiae fermentation product on microbiota populations of dogs subjected to travel stress." Journal of Animal Science 98, Supplement_4 (November 3, 2020): 62–63. http://dx.doi.org/10.1093/jas/skaa278.113.
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Abstract Previously, a Saccharomyces cerevisiae fermentation product (SCFP) positively altered fecal microbiota, fecal metabolites, and function of circulating immune cells in adult dogs. The objective of this study was to determine the fecal characteristics, microbiota, and metabolites of dogs subjected to travel stress. All procedures were approved by the Four Rivers Kennel IACUC prior to experimentation. Thirty-six adult dogs (mean age: 7.1 y; mean BCS: 4.9) were used. Dogs were randomly assigned to control or SCFP-supplemented (250 mg/day) diets and fed for a few months prior to a travel stress challenge. Fresh fecal samples were collected for the measurement of fecal characteristics, microbiota, and metabolites before and after travel stress. Fecal microbiota data were evaluated using QIIME2. All other data were analyzed using the Mixed Models procedure of SAS, with P < 0.05 considered statistically significant. There were no differences between treatments on fecal characteristics, metabolites, and bacterial alpha and beta diversity measures. However, fecal Turicibacter increased in dogs fed SCFP (0.8% to 1.2%, P = 0.03), but decreased in dogs fed control (1.2% to 0.7%, P = 0.03). Fecal Prevotella (5% to 7%, P = 0.004), Oscillospira (0.07% to 0.1%, P = 0.004) and Sutterella (3% to 4%, P = 0.01) increased after travel stress in dogs fed control. In contrast, fecal Clostridium (11% to 15%, P = 0.01), Faecalibacterium (6% to 8%, P = 0.003), and Allobaculum (1% to 2%, P = 0.02) increased and fecal Phascolarctobacterium (1.4% to 1.1%, P = 0.001) decreased after travel stress in dogs fed SCFP. Our data demonstrate that both travel stress and SCFP alter fecal microbiota in dogs.
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Young, K., S. A. Yeoh, M. Putman, E. Graef, F. Berenbaum, R. Conway, R. Grainger, et al. "POS0051 THE IMPACT OF COVID-19 ON RHEUMATOLOGY TRAINING: RESULTS FROM THE COVID-19 GLOBAL RHEUMATOLOGY ALLIANCE TRAINEE SURVEY." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 230.2–231. http://dx.doi.org/10.1136/annrheumdis-2021-eular.2236.
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Background:The COVID-19 pandemic has disrupted healthcare delivery and education of physicians, including rheumatology trainees.Objectives:To assess the impact of the COVID-19 pandemic on the clinical experiences, research opportunities, and well-being of rheumatology trainees.Methods:A voluntary, anonymous, web-based survey was administered in English, Spanish, or French from 19/08/2020 to 05/10/2020. Adult and paediatric rheumatology trainees worldwide in training in 2020 were invited to participate via social media and email. Using multiple choice questions, Likert scales, and free text answers, we assessed trainee patient care activities, redeployment, research, and well-being.Results:The 302 respondents were from 33 countries, with most (83%, 252/302) in adult rheumatology training. Many trainees (45%, 135/300) reported an increase in non-rheumatology clinical work (e.g. care of COVID-19 patients), with 52% of these (70/135) also continuing rheumatology clinical work. COVID-19 redeployment was not optional for 68% (91/134).Trainees reported a negative impact of the pandemic in their growth in rheumatology (Figure 1). They also reported a substantial impact on several training areas: outpatient clinics (79%, 238/302), inpatient consultations (59%, 177/302), formal teaching (55%, 167/302), procedures (53%, 147/302), teaching opportunities (52%, 157/302), and ultrasonography (36%, 110/302), with 87-96% perceiving a negative impact on these areas. Only 54% (159/294) reported feeling comfortable with their level of clinical supervision during the pandemic (Figure 1).Many trainees (46%, 128/280) reported changes in research experiences during the pandemic; 39% (110/285) reported that COVID-19 negatively affected their ability to continue their pre-pandemic research and 50% (142/285) reported difficulty maintaining research goals (Figure 1).Some rheumatology trainees reported having health condition(s) putting them at high risk for COVID-19 (10%, 30/302) and 14% of trainees (41/302) reported having had COVID-19 (Table 1). Only 53% (160/302) reported feeling physically safe in the workplace while 25% (76/302) reported not feeling physically safe; reasons included lack of training about COVID-19, lack of comfort in the clinical setting, insufficient personal protective equipment, immunocompromised state, and pregnancy. Half (151/302) reported burnout and 68% (204/302) an increase in stress from work during the pandemic (Figure 1), whilst 25% (75/302) reported that changes to their training programme negatively impacted their physical health.Conclusion:The COVID-19 pandemic has negatively impacted the experience of rheumatology training as well as the well-being of trainees globally. Our data highlight concerns for rheumatology trainees including research opportunities and clinical care which should be a focus for curriculum planning.Figure 1.Rheumatology trainee perceptions of pandemic impact and changes in training programme.Table 1.Estimated hazard ratios, adjusted for age and gender, for individuals with rheumatoid arthritisEuropen = 89ROWn = 213Combinedn = 302Disability1 (1)9 (4)10 (3)High risk7 (8)23 (11)30 (10)Pregnant4 (5)15 (7)19 (6)Shielding/Quarantining12 (13)70 (33)82 (27)Acquired COVID-1920 (22)21 (10)41 (14)Disclosure of Interests:Kristen Young: None declared, Su-Ann Yeoh: None declared, Michael Putman: None declared, Elizabeth Graef: None declared, Francis Berenbaum: None declared, Richard Conway: None declared, Rebecca Grainger Speakers bureau: Speaker fees from Abbvie, Janssen, Novartis, Pfizer, Cornerstones, all not related to this work, Consultant of: Consultancy fees from Abbvie, Janssen, Novartis, Pfizer, Cornerstones, all not related to this work, Grant/research support from: Travel assistance from Pfizer, not related to this work, Adam Kilian: None declared, Maximilian Konig: None declared, Jean Liew Grant/research support from: Research grant from Pfizer unrelated to this manuscript, Pedro M Machado Speakers bureau: Speaker fees from Abbvie, BMS, Celgene, Eli Lilly, Janssen, MSD, Novartis, Orphazyme, Pfizer, Roche and UCB, all unrelated to this manuscript, Consultant of: Consulting fees from Abbvie, BMS, Celgene, Eli Lilly, Janssen, MSD, Novartis, Orphazyme, Pfizer, Roche and UCB, all unrelated to this manuscript, Sebastian E. Sattui: None declared, Jeffrey Sparks Consultant of: Consultancy for Bristol-Myers Squibb, Gilead, Inova Diagnostics, Optum, and Pfizer unrelated to this manuscript, Grant/research support from: Research support from Bristol-Myers Squibb unrelated to this manuscript, Paul Sufka: None declared, Manuel Ugarte-Gil Grant/research support from: Research grants from Janssen and Pfizer unrelated to this manuscript, Laura Upton: None declared, Zachary Wallace: None declared, Jinoos Yazdany Consultant of: Consultancy for Astra Zeneca, Eli Lilly, and Pfizer, not related to this work, Grant/research support from: Research grants from Gilead and Pfizer, not related to this work, Arundathi Jayatilleke: None declared.
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Chan, Tracey Evans. "The regulatory challenges of international transplant medicine." Medical Law International 12, no. 3-4 (December 2012): 277–99. http://dx.doi.org/10.1177/0968533213475915.
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Transplant tourism is spurred by the global shortage of organs and the potential for regulatory arbitrage in purchasing an organ in jurisdictions that do not prohibit sale or lack effective regulatory mechanisms to enforce prohibition. Various nations once identified as transplant tourism hotspots have since enacted legislation prohibiting organ sales and emplaced regulatory oversight. However, concerns persist that the legitimization of altruistic unrelated living donor transplants conceals underlying commercialism and unethical practices. These concerns are heightened when transplant candidates travel across borders in search of international transplant medicine. This article examines the regulatory challenges associated with differentiating international transplant medicine from transplant tourism, and various regulatory mechanisms that have been developed to address them from the domestic perspective – in particular, those recently implemented in the Singapore. It seeks to identify the strengths and weaknesses of the Singapore system and what lessons this has for international standards and practices.
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Cepeda, Joana, Paula Milheiro-Oliveira, and Cândida Abreu. "O que Sabem os Viajantes Portugueses Sobre Malária? Avaliação Pré-Consulta de Medicina de Viagem." Acta Médica Portuguesa 31, no. 12 (December 28, 2018): 714. http://dx.doi.org/10.20344/amp.10656.
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Introduction: The knowledge of transmission, prevention and symptoms of malaria is essential for travellers’ safety. In real life, what do Portuguese travellers know about malaria before a Travel Medicine consultation? How can we, through this consultation, improve their knowledge?Material and Methods: Before an appointment with a specialist in Travel Medicine, 80 adult travellers filled a questionnaire that included demographic aspects, characteristics of the trip and knowledge about malaria. Data were analysed using descriptive statistics and multifactorial variance analysis.Results: The travellers’ ages fell in the range 20 - 80 years, 51% were male and 74% of the travellers had a university degree level of education. For 74% of the travellers, this was the first Travel Medicine consultation. Half of the travellers planed trips lasting no more than 14 days, mainly for tourism. The average percentage of correct answers about malaria given by a traveller was 63%. Travellers who had previously attended a Travel Medicine appointment exhibit a statistically significant difference in knowledge comparing to those who attend Travel Medicine appointment for the first time, and this was more evident in the sample composed of travellers without higher education. The clinical manifestations and prevention had the lowest number of correct answers among the travellers.Discussion: These travellers appear to have good knowledge about malaria but some misconceptions prevail.Conclusion: The Travel Medicine consultation seems important to raise awareness in the population about malaria, particularly for travellers without higher education. The prevention and the recognition of malaria symptoms must be prioritized during Travel Medicine consultations and the information given adapted to the traveller’s characteristics.
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Juo, Yen-yi, Alexis Woods, Ryan Ou, Gianna Ramos, Richard Shemin, and Peyman Benharash. "Does Travel Distance Affect Readmission Rates after Cardiac Surgery?" American Surgeon 83, no. 10 (October 2017): 1170–73. http://dx.doi.org/10.1177/000313481708301032.
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With emphasis on value-based health care, empiric models are used to estimate expected read-mission rates for individual institutions. The aim of this study was to determine the relationship between distance traveled to seek surgical care and likelihood of readmission in adult patients undergoing cardiac operations at a single medical center. All adults undergoing major cardiac surgeries from 2008 to 2015 were included. Patients were stratified by travel distance into regional and distant travel groups. Multivariable logistic regression models were developed to assess the impact of distance traveled on odds of readmission. Of the 4232 patients analyzed, 29 per cent were in the regional group and 71 per cent in the distant. Baseline characteristics between the two groups were comparable except mean age (62 vs 61 years, P < 0.01) and Caucasian race (59 vs 73%, P < 0.01). Distant travel was associated with a significantly longer hospital length of stay (11.8 vs 10.5 days, P < 0.01) and lower risk of readmission (9.5 vs 13.4%, P < 0.01). Odds of readmission was inversely associated with logarithm of distance traveled (odds ratio 0.75). Travel distance in patients undergoing major cardiac surgeries was inversely associated with odds of readmission.
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Luks, Andrew M., Karen Stout, and Erik R. Swenson. "Evaluating the Safety of High-altitude Travel in Patients with Adult Congenital Heart Disease." Congenital Heart Disease 5, no. 3 (May 2010): 220–32. http://dx.doi.org/10.1111/j.1747-0803.2010.00415.x.
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Farooq, Muhammad, Jennifer Gibson-Corrado, Jennifer A. Knapp, Rui-De Xue, Michael L. Smith, Anna Katrina C. Briley, Alex R. Richardson, and James Cilek. "Effect of Travel Speed on Dispersion of Aqualuer 20-20 Sprayed by a Truck-Mounted Ultra-Low–Volume Sprayer Against Caged Aedes aegypti1." Journal of the American Mosquito Control Association 34, no. 1 (March 1, 2018): 70–74. http://dx.doi.org/10.2987/17-6648.1.
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ABSTRACT The effect of travel speed of a truck-mounted ultra-low–volume (ULV) sprayer on its application efficacy was studied at St. Johns County Fairground, Elkton, FL, during summer 2015. The efficacy was assessed by spray deposition, droplet size spectrum, and 24-h mortality of caged adult Aedes aegypti, using 2 rows of sampling locations, 15 m apart and spread up to 122 m from the spray. Each location had a bioassay cage and an impinger droplet sampler, 1 m apart from each other, at 1.5 m off the ground. Aqualuer® 20-20 (20.6% permethrin AI and 20% piperonyl butoxide) was applied at the maximum label rate, travelling at 8, 16, and 32 km/h. Three replications were completed on 3 days at least a week apart, with 1 replication of each travel speed per day. On each application day the travel speeds were rotated. Overall, a travel speed of 32 km/h achieved the highest efficacy of Aqualuer® 20-20, followed by 16 km/h, and then 8 km/h, in an open field. In general, droplet size, deposition, and mosquito mortality increased with increasing travel speed. The increased travel speed will also enhance the work rate of a sprayer and operator, thus reducing the cost of ULV applications.
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Dodge, Kara L., Benjamin Galuardi, and Molly E. Lutcavage. "Orientation behaviour of leatherback sea turtles within the North Atlantic subtropical gyre." Proceedings of the Royal Society B: Biological Sciences 282, no. 1804 (April 7, 2015): 20143129. http://dx.doi.org/10.1098/rspb.2014.3129.
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Leatherback sea turtles ( Dermochelys coriacea ) travel thousands of kilometres between temperate feeding and tropical breeding/over-wintering grounds, with adult turtles able to pinpoint specific nesting beaches after multi-year absences. Their extensive migrations often occur in oceanic habitat where limited known sensory information is available to aid in orientation. Here, we examined the migratory orientation of adult male, adult female and subadult leatherbacks during their open-ocean movements within the North Atlantic subtropical gyre by analysing satellite-derived tracks from fifteen individuals over a 2-year period. To determine the turtles' true headings, we corrected the reconstructed tracks for current drift and found negligible differences between current-corrected and observed tracks within the gyre. Individual leatherback headings were remarkably consistent throughout the subtropical gyre, with turtles significantly oriented to the south-southeast. Adult leatherbacks of both sexes maintained similar mean headings and showed greater orientation precision overall. The consistent headings maintained by adult and subadult leatherbacks within the gyre suggest use of a common compass sense.
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Chang, Sanders, Nathan E. Goldstein, and Kavita V. Dharmarajan. "Managing an Older Adult with Cancer: Considerations for Radiation Oncologists." BioMed Research International 2017 (2017): 1–13. http://dx.doi.org/10.1155/2017/1695101.
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Older adults with cancer present a unique set of management complexities for oncologists and radiation oncologists. Prognosis and resilience to cancer treatments are notably dependent on the presence or risk of “geriatric syndromes,” in addition to cancer stage and histology. Recognition, proper evaluation, and management of these conditions in conjunction with management of the cancer itself are critical and can be accomplished by utilization of various geriatric assessment tools. Here we review principles of the geriatric assessment, common geriatric syndromes, and application of these concepts to multidisciplinary oncologic treatment. Older patients may experience toxicities related to treatments that impact treatment effectiveness, quality of life, treatment-related mortality, and treatment compliance. Treatment-related burdens from radiotherapy are increasingly important considerations and include procedural demands, travel, costs, and temporary or permanent loss of functional independence. An overall approach to delivering radiotherapy to an older cancer patient requires a comprehensive assessment of both physical and nonphysical factors that may impact treatment outcome. Patient and family-centered communication is also an important part of developing a shared understanding of illness and reasonable expectations of treatment.
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Van Hoeck, Kathy. "Using Brassica Butterflies as a Model Organism for AP Biology Lab 11." American Biology Teacher 72, no. 6 (August 1, 2010): 361–64. http://dx.doi.org/10.1525/abt.2010.72.6.9.
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Advanced Placement Biology Lab 11 has used pillbugs as the model organism and choice chambers so that they can travel between two environments. I used cabbage white butterflies as the model organism. Each student was given their own larva and observed metamorphosis, choice behaviors of the larva, and mating behaviors of adult butterflies.
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Tun, Sai Thein Than, Myo Chit Min, Ricardo Aguas, Kimberly Fornace, Gay Nay Htoo, Lisa J. White, and Daniel M. Parker. "Human movement patterns of farmers and forest workers from the Thailand-Myanmar border." Wellcome Open Research 6 (June 14, 2021): 148. http://dx.doi.org/10.12688/wellcomeopenres.16784.1.
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Background: Human travel patterns play an important role in infectious disease epidemiology and ecology. Movement into geographic spaces with high transmission can lead to increased risk of acquiring infections. Pathogens can also be distributed across the landscape via human travel. Most fine scale studies of human travel patterns have been done in urban settings in wealthy nations. Research into human travel patterns in rural areas of low- and middle-income nations are useful for understanding the human components of epidemiological systems for malaria or other diseases of the rural poor. The goal of this research was to assess the feasibility of using GPS loggers to empirically measure human travel patterns in this setting, as well as to quantify differing travel patterns by age, gender, and seasonality. Methods: In this pilot study we recruited 50 rural villagers from along the Myanmar-Thailand border to carry GPS loggers for the duration of a year. The GPS loggers were programmed to take a time-stamped reading every 30 minutes. We calculated daily movement ranges and multi-day trips by age and gender. We incorporated remote sensing data to assess patterns of days and nights spent in forested or farm areas, also by age and gender. Results: Our study showed that it is feasible to use GPS devices to measure travel patterns, though we had difficulty recruiting women and management of the project was relatively intensive. We found that older adults traveled farther distances than younger adults and adult males spent more nights in farms or forests. Conclusion: The results of this study suggest that further work along these lines would be feasible in this region. Furthermore, the results from this study are useful for individual-based models of disease transmission and land use.
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Crook, Gabrielle M., Mark E. West, and Tian P. S. Oei. "A Comparison of Estimates of the Prevalence of Heavy Drinkers in Local Regions of Queensland." Australian & New Zealand Journal of Psychiatry 32, no. 4 (August 1998): 504–10. http://dx.doi.org/10.3109/00048679809068324.
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Objective: This study developed and compared separate estimates of the number of heavy drinkers (the in-need population for alcohol treatment interventions) across eight local regions in Queensland. Method: Estimates were based on: (i) a self-report population survey of alcohol consumption; and (ii) an application of the Ledermann log-normal distribution of consumption model to liquor sale figures. Results: Estimates based on the 1989–1990 National Health Survey (NHS) data indicated that 10.98% (n = 83 880) of adult male drinkers and 1.25% (n = 6581) of adult female drinkers in Queensland (total = 90 461) were on average drinking the equivalent of six or more standard drinks a day in the week prior to the survey (4.74% of Queensland adult drinkers, n = 90,461). Estimates based on the Ledermann model indicated that 12.18% of adult Queensland drinkers (n = 232,283) were drinking six or more standard drinks a day. Estimates based on the Ledermann model were 157% larger than estimates based on NHS data (i.e. a difference of 141 821 heavy drinkers), with large variations in the two estimates across local regions. Conclusion: The NHS data appears to underestimate the population of heavy drinkers, whereas the Ledermann model overestimates it. In this situation, it seems preferable to use the more conservative self-report survey estimates.
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Trbojevic, Jasna B., Vidosava B. Nesic, and Biljana B. Stojimirovic. "Quality of Life of Elderly Patients Undergoing Continuous Ambulatory Peritoneal Dialysis." Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis 21, no. 3_suppl (December 2001): 300–303. http://dx.doi.org/10.1177/089686080102103s53.
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Objective The aim of the present study was to evaluate the impact of continuous ambulatory peritoneal dialysis (CAPD) on the lifestyle of elderly patients. Patients and Methods Aspects of health-related quality of life (QL) were studied in 48 patients (16 men, 32 women) in end-stage chronic renal failure (ESRF) undergoing CAPD at the Clinic of Nephrology, Clinical Centre of Serbia. The first group comprised 20 adult patients (8 men, 12 women; age range: 35 – 59 years). The second group consisted of 28 older adult patients (8 men, 20 women; age range: 65 – 75 years). Mean length of CAPD treatment was 5.2 years in the first group and 3.67 years in the second group. Fifteen QL variables were investigated: marital status, family relationships, working ability, sleep, tiredness, appetite, wound healing, hobby, sports, friendships, sexual activity, mood, travel, self management, and happiness. Results The results showed that, in the examined groups, marital status and relationships with family members weren't influenced at all by dialysis. In both groups, CAPD had a negative influence on ability to bear cold and to travel, but other life functions were not significantly affected. Elderly patients had a significantly worse appetite ( p = 0.03, Fisher test) and mood ( p = 0.045, Fisher test) than did younger adults. In other examined variables, no statistically significant differences were found between the groups. Conclusions Lack of large, statistically significant differences between the groups suggests that CAPD has an equal influence on quality of life in younger and older adult patients.
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Sanchez, Sarimer, Eileen Searle, David Rubins, Sayon Dutta, Winston Ware, Paul Biddinger, and Erica Shenoy. "Implementation of an Electronic Travel Navigator to Enable "Identify-Isolate-Inform" for Emerging Infectious Diseases." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s273—s275. http://dx.doi.org/10.1017/ice.2020.843.
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Background: Travel screening can facilitate the identification of patients at risk for emerging infectious diseases, such as Middle East respiratory syndrome (MERS). A travel navigator with associated decision support through a best practice advisory (BPA) was implemented in an electronic health record to build upon the CDC identify-isolate-inform framework. Compliance with documentation of travel history, symptom screening when appropriate, and isolation of suspect MERS patients were assessed. Methods: Adult and pediatric emergency department encounters at the Massachusetts General Hospital, a 1,035-bed, tertiary-care, academic health center in Boston, Massachusetts, from August 2018 to October 2019, were included. We categorized an encounter as adherent to initial travel screening if providers answered foreign, domestic, or no travel to the screen. Encounters were defined as nonadherent if they were recorded as unknown or if an answer was not selected. Adherence to completion of data entry for the subgroup of patients with documented foreign travel was further assessed for region- and country-level specification, completion of symptom screen, and response to the MERS BPA (Fig. 1). Results: In total, 127,866 encounters were included, of which 105,593 (83%) were adherent to initial travel screening. Among 4,498 encounters with documented foreign travel, 2,970 (66%) specified the region of travel, and 710 (16%) selected a country of travel from the listing. Moreover, 214 encounters had documented travel to the Middle East. Selection of Middle East or 1 of the 13 countries identified by the CDC as at risk for MERS triggered symptom screening for fever and cough, which was performed in 139 encounters (65%). Of these, 95 encounters documented absence of fever and cough, 15 documented fever and cough, 12 documented a cough alone, and 17 documented a fever alone through reporting or obtaining vitals. The MERS BPA was triggered in 37 encounters; 10 patients were ordered for isolation using the BPA. Of these, 4 patients met CDC criteria for a MERS patient under investigation and were tested; all were negative. Conclusions: Initial screening to document foreign travel is completed at a high rate; however, use of the travel navigator to specify region and country, key components necessary to prompt clinicians for symptom screening, are documented in a minority of encounters. Future interventions are needed to improve region and country capture and appropriate symptom screening, with isolation when appropriate.Funding: NoneDisclosures: None
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Stronks, Els. "Curiosity, youth, and knowledge in the visual and textual culture of the Dutch Republic." Science in Context 32, no. 2 (June 2019): 213–36. http://dx.doi.org/10.1017/s0269889719000152.
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ArgumentThe imitation of adults was the dominant educational early modern model, as it had been from the classical era. Yet, from 1500 onward, this traditional model clashed with new pedagogical ideals that explored if and how the youthful mind differed from the adult. To investigate this clash, I examine individual and aggregate cases – taken from the Dutch (illustrated) textual culture – representing conceptualizations of what has been labelled “the curiosity family” (concepts such as curiosity, inquisitiveness, invention). As previously established, during the seventeenth century, curiosity turned from a vice to a virtue among adults. Textual evidence suggests that for the early modern Dutch youth, docility, long valued, remained the guiding ideal. Shortly after 1700, however, two changes can be detected: for youth, travel literature and travel as a metaphor became a means to explore the world without adults; and for adults, the experimental learning style of the young became a new learning model.
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Lahiri, Raja, Udit Chauhan, Ajay Kumar, and Nisanth Puliyath. "Undiagnosed bilateral complete cervical rib with subclavian artery aneurysm presenting as acute ischaemic limb following high-altitude expedition." BMJ Case Reports 14, no. 2 (February 2021): e241194. http://dx.doi.org/10.1136/bcr-2020-241194.
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Arterial thoracic outlet syndrome is relatively rare and often exclusively seen in the presence of bony anomalies. High-altitude (HA) travel is commonly associated with thrombosis; however, arterial thromboembolism is less frequently described. We describe a case of a young man with undiagnosed bilateral cervical rib, who went for an HA trek, subsequent to which developed acute limb ischaemia of right arm. Diagnostic workup revealed a subclavian artery aneurysm as well along with complete bony bilateral cervical ribs. Thoracic outlet syndrome should be kept as a differential diagnosis in a case of acute limb ischaemia in a healthy adult.
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Hsu, Chien-Ning, and You-Lin Tain. "Light and Circadian Signaling Pathway in Pregnancy: Programming of Adult Health and Disease." International Journal of Molecular Sciences 21, no. 6 (March 23, 2020): 2232. http://dx.doi.org/10.3390/ijms21062232.
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Light is a crucial environmental signal that affects elements of human health, including the entrainment of circadian rhythms. A suboptimal environment during pregnancy can increase the risk of offspring developing a wide range of chronic diseases in later life. Circadian rhythm disruption in pregnant women may have deleterious consequences for their progeny. In the modern world, maternal chronodisruption can be caused by shift work, jet travel across time zones, mistimed eating, and excessive artificial light exposure at night. However, the impact of maternal chronodisruption on the developmental programming of various chronic diseases remains largely unknown. In this review, we outline the impact of light, the circadian clock, and circadian signaling pathways in pregnancy and fetal development. Additionally, we show how to induce maternal chronodisruption in animal models, examine emerging research demonstrating long-term negative implications for offspring health following maternal chronodisruption, and summarize current evidence related to light and circadian signaling pathway targeted therapies in pregnancy to prevent the development of chronic diseases in offspring.
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Gravningen, Kirsten, Nigel Field, Hege Salvesen Blix, Anne Mette Asfeldt, and Lars Småbrekke. "Non-prescription purchase of antibiotics during travel abroad among a general adult population in Norway: Findings from the seventh Tromsø Study." PLOS ONE 15, no. 2 (February 13, 2020): e0228792. http://dx.doi.org/10.1371/journal.pone.0228792.
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Wall, Catherine S., Rose S. Bono, Rebecca C. Lester, Cosima Hoetger, Thokozeni Lipato, Mignonne C. Guy, Thomas E. Eissenberg, Warren K. Bickel, Andrew J. Barnes, and Caroline O. Cobb. "Triangulating abuse liability assessment for flavoured cigar products using physiological, behavioural economic and subjective assessments: a within-subjects clinical laboratory protocol." BMJ Open 8, no. 10 (October 2018): e023850. http://dx.doi.org/10.1136/bmjopen-2018-023850.
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IntroductionIn the USA, Food and Drug Administration regulations prohibit the sale of flavoured cigarettes, with menthol being the exception. However, the manufacture, advertisement and sale of flavoured cigar products are permitted. Such flavourings influence positive perceptions of tobacco products and are linked to increased use. Flavourings may mask the taste of tobacco and enhance smoke inhalation, influencing toxicant exposure and abuse liability among novice tobacco users. Using clinical laboratory methods, this study investigates how flavour availability affects measures of abuse liability in young adult cigarette smokers. The specific aims are to evaluate the effect of cigar flavours on nicotine exposure, and behavioural and subjective measures of abuse liability.Methods and analysesParticipants (projected n=25) are healthy smokers of five or more cigarettes per day over the past 3 months, 18–25 years old, naive to cigar use (lifetime use of 50 or fewer cigar products and no more than 10 cigars smoked in the past 30 days) and without a desire to quit cigarette smoking in the next 30 days. Participants complete five laboratory sessions in a Latin square design with either their own brand cigarette or a session-specific Black & Mild cigar differing in flavour (apple, cream, original and wine). Participants are single-blinded to cigar flavours. Each session consists of two 10-puff smoking bouts (30 s interpuff interval) separated by 1 hour. Primary outcomes include saliva nicotine concentration, behavioural economic task performance and response to various questionnaire items assessing subjective effects predictive of abuse liability. Differences in outcomes across own brand cigarette and flavoured cigar conditions will be tested using linear mixed models.Ethics and disseminationThe Virginia Commonwealth University Institutional Review Board approved the study (VCU IRB: HM20007848). Dissemination channels for study findings include scientific journals, scientific meetings, and policy briefs.Trial registration numberNCT02937051.
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Ansari, Mohammed T., Mohammad T. Mahmood, and Johan PE Karlberg. "The association between seated immobility and local lower-limb venous coagulability in healthy adult volunteers: a simulation of prolonged travel immobility." Blood Coagulation & Fibrinolysis 17, no. 5 (July 2006): 335–41. http://dx.doi.org/10.1097/01.mbc.0000233362.80486.6c.
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Mueller, Bernhard K., Toshihide Yamashita, Gregor Schaffar, and Reinhold Mueller. "The role of repulsive guidance molecules in the embryonic and adult vertebrate central nervous system." Philosophical Transactions of the Royal Society B: Biological Sciences 361, no. 1473 (August 2, 2006): 1513–29. http://dx.doi.org/10.1098/rstb.2006.1888.
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During the development of the nervous system, outgrowing axons often have to travel long distances to reach their target neurons. In this process, outgrowing neurites tipped with motile growth cones rely on guidance cues present in their local environment. These cues are detected by specific receptors expressed on growth cones and neurites and influence the trajectory of the growing fibres. Neurite growth, guidance, target innervation and synapse formation and maturation are the processes that occur predominantly but not exclusively during embryonic or early post-natal development in vertebrates. As a result, a functional neural network is established, which is usually remarkably stable. However, the stability of the neural network in higher vertebrates comes at an expensive price, i.e. the loss of any significant ability to regenerate injured or damaged neuronal connections in their central nervous system (CNS). Most importantly, neurite growth inhibitors prevent any regenerative growth of injured nerve fibres. Some of these inhibitors are associated with CNS myelin, others are found at the lesion site and in the scar tissue. Traumatic injuries in brain and spinal cord of mammals induce upregulation of embryonic inhibitory or repulsive guidance cues and their receptors on the neurites. An example for embryonic repulsive directional cues re-expressed at lesion sites in both the rat and human CNS is provided with repulsive guidance molecules, a new family of directional guidance cues.
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Yu, Yanqiu, Mason M. C. Lau, Hui Jiang, and Joseph T. F. Lau. "Prevalence and Factors of the Performed or Scheduled COVID-19 Vaccination in a Chinese Adult General Population in Hong Kong." Vaccines 9, no. 8 (August 2, 2021): 847. http://dx.doi.org/10.3390/vaccines9080847.
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Background: Globally, COVID-19 vaccination programs have been rolled out. To inform health promotion, this study investigated the prevalence and associated factors of performance or being scheduled to perform at least one dose of COVID-19 vaccination (PSCV) in a Chinese adult general population. Methods: An anonymous, random telephone survey interviewed 500 adults aged 18–75 in Hong Kong, China from 14–27 May 2021. Results: The prevalence of PSCV was 21.0%, which was significantly lower among females and those aged ≤30. Positively associated factors of PSCV included perceived protection effect of vaccination, self-perceived physical fitness for vaccination, compulsory COVID-19 testing experience, perceived need to travel, general trust toward the government, and trust toward the governmental vaccination program, while negatively associated factors included perceived low efficacy of vaccination, concerns about side effects, and chronic disease status. Furthermore, the association between sex and PSCV was fully mediated by stronger concern about side effects and lower levels of self-perceived physical fitness for COVID-19 vaccination among females than males. Conclusion: Moderately low prevalence of COVID-19 vaccination was observed in Hong Kong, where there was no shortage of vaccine supply. To achieve herd immunity, health promotion is greatly warranted and may incorporate messages based on the findings of this study.
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Clarke, S. C., and M. McIntyre. "The incidence ofCyclospora cayetanensisin stool samples submitted to a district general hospital." Epidemiology and Infection 117, no. 1 (August 1996): 189–93. http://dx.doi.org/10.1017/s0950268800001308.
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SummaryCyclospora cayetanensisis the cause of a prolonged diarrhoeal syndrome. In the UK most cases are seen in travellers who have returned from countries in which the organism is endemic. The purpose of this investigation was to determine the incidence ofC. cayetanensisin stool samples submitted to a district general hospital. A total of 6151 stools from 5374 different patients were screened for the presence ofC. cayetanensisover a 1-year period using the modified Ziehl-Neelsen technique. Oocysts ofC. cayetanensiswere found in 7 stools (0·1%) from 4 patients (0·07%). All four patients were adult travellers who had visited countries in whichC. cayetanensisis known to be endemic. In the population of this study,C. cayetanensiswas found to be a rare cause of diarrhoea. AlthoughC. cayetanensisinfection should be considered in individuals of all ages who have lived in, or have travelled to endemic areas, there is no need to screen stool samples for the organism in those without such a travel history.
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Segal, Nancy L. "Twin Reunions: The Science Behind the Fascination/Twin Research Reports: Altitude and Hypoxia; Twin Pregnancy Outcomes; Space Mission/Media Highlights: Chinese Twins Reunited; Twin Loss Discovered; Hidden Twins; Twin Euthanasia; Twin Savior." Twin Research and Human Genetics 16, no. 5 (September 9, 2013): 1008–13. http://dx.doi.org/10.1017/thg.2013.62.
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A description of the unique qualitative features of reunions between separated monozygotic twins is presented. The scientific implications of these observations are considered with reference to understanding human social behavior in general. This is followed by summaries of twin research on altitude and hypoxia, pregnancy outcomes, and space travel. Finally, recent accounts of twins in the media are noted; in particular, a rare reunion of adult monozygotic male Chinese twins, a novelist's personal discovery of twin loss, two renowned but ‘hidden’ twins, the moving story of an identical Belgian pair, and a twin savior.
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Rudder, TH, RJ Webber, PT Knights, and PK O'Rourke. "Productivity of Hereford, highgrade Simmental and Belmont Red beef herds in central Queensland 6. Whole herd income and gross margins." Australian Journal of Experimental Agriculture 32, no. 8 (1992): 1023. http://dx.doi.org/10.1071/ea9921023.
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Hereford, highgrade Simmental, and Belmont Red breeding and fattening herds were modelled using comparative productive traits established in a research program. These traits included survival and reproductive rates and liveweights of breeders grazing predominately improved pasture, and growth rates from weaning to sale under either pasture or pasture-plus-crop nutritional regimes. It was assumed that steers were targeted to the grass-fed Japanese market, which required carcass weights of 280-380 kg. Net income was estimated by developing a hypothetical property capable of supporting 1000 adult equivalents and using best-bet estimates of the variable and fixed costs of production for each herd. Belmont Red model herds produced higher net income ($A58 800) than Hereford ($19 000) or highgrade Simmental ($8 000) herds under the pastureonly regime. When surplus heifers and steers had access to summer and winter crops as well as pasture, net income was Belmont Red $60 600, Hereford $34 400, and highgrade Simmental$20 400. The lower earning capacity of the Hereford than the Belmont Red was due to lower herd output; higher variable costs, mainly due to higher costs for bulls and for tick and dystocia control; and lower prices, due to a smaller proportion of cattle meeting preferred fat scores. The difference between the Hereford and highgrade Simmental herds was mainly due to price reductions for the highgrade Simmental slaughter cattle because of failure to meet preferred fat scores. Their large mature size and, hence, fewer numbers to make up 1000 adult equivalents also contributed.
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Stancliffe, Roger J., Kelly M. Nye-Lengerman, and Julie E. D. Kramme. "Aging, Community-Based Employment, Mobility Impairment, and Retirement: National Core Indicators–Adult Consumer Survey Data." Research and Practice for Persons with Severe Disabilities 44, no. 4 (October 31, 2019): 251–66. http://dx.doi.org/10.1177/1540796919882921.
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Little is known about how, when, or why individuals with intellectual and developmental disabilities (IDD) retire. Recognizing the changing needs of older adults with IDD is critical to support person-driven services and development of best practices in aging transitions. Using secondary analysis of the 2016 to 2017 National Core Indicators–Adult Consumer Survey (NCI-ACS) data for adults with IDD, we examined the relation between independent mobility (i.e., without aids), age group, level of intellectual disability, and type of employment/activity program, with a focus on mobility and community-based employment in older age groups. There was an overall age-related decline in mobility, but the prevalence of mobility impairment by age group was related to employment type. The percentage who were independently mobile was highest for community employment in every age group. The percentage of individuals by age group in community employment fell significantly from middle age onward, suggesting some former community-based workers had retired. There was no significant age-related difference in the percentage in facility-based employment across these age groups. Mobility limitations may be a barrier to obtaining or retaining community-based employment. Age-related mobility impairment may be associated with premature retirement, and could affect travel to and from work, undertaking work tasks, or both. Closer examination is needed of aging, community employment, and age-related mobility limitations to understand the specific causes of these effects on employment and identify supports and accommodations.
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Zhu, Xuemei, B. Arch, and Chanam Lee. "Personal, Social, and Environmental Correlates of Walking to School Behaviors: Case Study in Austin, Texas." Scientific World JOURNAL 8 (2008): 859–72. http://dx.doi.org/10.1100/tsw.2008.63.
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Walking is an affordable and environmentally clean mode of transportation that can bring additional benefits as healthy physical activity. This cross-sectional study examines the prevalence and correlates of walking to or from school in eight elementary schools in Austin, Texas, which have high percentages of low-income, Hispanic students. A survey of 1,281 parents was conducted, including questions about personal, social, and environmental factors that may influence their decisions on the children's school transportation. Binary logistic regressions were used to estimate the odds of choosing walking as the children's typical school travel mode. The results showed that walking was a typical mode for 28 and 34% of trips to and from school, respectively, and mostly accompanied by an adult. Parents' education level, family's car ownership, children's and parents' personal barriers, and having the school bus service reduced the likelihood of walking, while positive peer influences encouraged walking. Among the physical environmental factors, living close to school was the strongest positive predictor; safety concerns and the presence of highway or freeway en route were negative correlates. We concluded that the location of school is a key, as it determines the travel distance and the presence of highway or freeway en route. In addition to environmental improvements, educational and other assistance programs are needed for both parents and children to overcome their personal barriers and safety concerns. Health and disparity issues require further attention, as many underprivileged children have no other means of school transportation but walking in unsafe and poor environments.
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Candy, Kerdalidec, Mohammad Akhoundi, Christiane Bruel, and Arezki Izri. "Ineffectiveness of Insecticide Bendiocarb Against a Cimex lectularius (Hemiptera: Cimicidae) Population in Paris, France." Journal of Medical Entomology 55, no. 6 (July 26, 2018): 1648–50. http://dx.doi.org/10.1093/jme/tjy126.
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Abstract Bed bugs, nocturnal ectoparasites adapted to feed on humans, have demonstrated a global resurgence since 1990s, presumably due to increased international travel and insecticide resistance. Resistance to insecticides has restricted the ability to manage bed bug populations. We evaluated the susceptibility of Cimex lectularius L. (Hemiptera: Cimicidae) collected from five districts in Paris against bendiocarb, a carbamate insecticide. The susceptible strain of C. lectularius from London included in our experiments as a control. Mortality of adult bed bugs was assessed after exposure to a fixed concentration of bendiocarb (80%) at intervals ranging from 15 min to 72 h. Mortality in samples ranged from 14% in Bobigny to 0% in Paris 15th arrondissement and Drancy. Bioassays with bendiocarb insecticide on C. lectularius revealed high levels of resistance in Paris.
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Biuw, Martin, Christian Lydersen, P. J. Nico de Bruyn, Aline Arriola, Greg G. J. Hofmeyr, Petrus Kritzinger, and Kit M. Kovacs. "Long-range migration of a chinstrap penguin from Bouvetøya to Montagu Island, South Sandwich Islands." Antarctic Science 22, no. 2 (December 14, 2009): 157–62. http://dx.doi.org/10.1017/s0954102009990605.
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AbstractWe describe a long-range migration of a pre-moulting adult chinstrap penguin from Bouvetøya, a small relatively recently established colony, to the South Sandwich Islands, where large, established colonies of this species reside. The trip lasted around three weeks, covered ∼3600 km, and the time of arrival was consistent with the annual moult. The bird did not travel along the shortest path or along a constant bearing, but instead followed what appeared to be a series of two or three rhumb lines of constant bearing. Small southward and northward deviations from the general path were consistent with local water currents. Travel speeds were high during daylight but decreased at night, suggesting that resting or opportunistic feeding occurred preferentially at night. While long-range winter migrations of chinstraps to feeding areas in the vicinity of distant colonies have been previously described, this is the first observation of such a trip during the period between breeding and moulting, and the first record of an individual actually arriving at one of these distant colonies. This has implications for understanding population structure and management of this important Southern Ocean predator.
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Awasthi, Rakesh, Karen Thudium Mueller, Gregory A. Yanik, Constantine S. Tam, Susana Rives, Joseph P. McGuirk, Michael A. Pulsipher, et al. "Evaluation of In Vivo CAR Transgene Levels in Relapsed/Refractory Pediatric and Young Adult ALL and Adult DLBCL Tisagenlecleucel-Treated Patients." Blood 132, Supplement 1 (November 29, 2018): 899. http://dx.doi.org/10.1182/blood-2018-99-116385.
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Abstract Background Quantitative polymerase chain reaction (qPCR) is an analytical method that has been used to investigate the in vivo kinetics of chimeric receptor antigen (CAR) transgene following the infusion of tisagenlecleucel. B cell aplasia, likely an "on-target toxicity" of tisagenlecleucel, has been considered a measure of functional persistence. (Maude SL et al. Blood 2015;125(26):4017-4023) Although the CAR transgene can be detected in peripheral blood of tisagenlecleucel treated patients, it is unclear whether CAR transgene detection by qPCR could be reliably used to inform treatment decision in an individual patient. Methods Transgene levels in blood measured by qPCR from pivotal phase II studies in relapsed/refractory (r/r) pediatric and young adult acute lymphoblastic leukemia (B-ALL) patients (pts) (ELIANA [NCT02435849, N=75]; ENSIGN [NCT02228096, N=29]) and adult diffuse large B cell lymphoma (DLBCL) pts (JULIET [NCT02445248, N=93]) were used to investigate the relationship between transgene persistence and clinical response. Results To determine whether CAR qPCR measurements are associated with or predictive of response, CAR transgene levels and timing of peak levels were examined. In both ALL and DLBCL pts, there were detectable CAR transgene levels by qPCR in both responders and non-responders. The geometric mean maximal expansion (geo mean Cmax) was similar between responding and non-responding adult DLBCL pts, while 1.7 fold differences were observed in pediatric ALL pts (geo mean Cmax in copies/µg: responders, 32700, n=79; non-responders, 19500, n=10; Table 1). For both DLBCL and ALL pts, high inter-individual variability in transgene levels was noted. Similarly, higher CAR-T cell expansion from flow cytometry data pooled from responding pediatric ALL and chronic lymphocytic leukemia (CLL) pts were observed relative to non-responding pts (Mueller KT et al. Blood 2017;130(21):2317-2325), while the levels in DLBCL pts were comparatively lower in blood, likely due to partitioning of functional CAR-T cells to the target sites including lymph nodes. The median time to maximal transgene level ranged from 9-10 days in DLBCL responders and non-responders and pediatric ALL responders, while non-responding pediatric ALL pts showed delayed expansion with median Tmax of 20 days. The median time corresponding to last quantifiable transgene level (Tlast), an indicator of persistence, was higher in responding pts compared to non-responding pts, indicating a trend for longer persistence in both DLBCL and ALL pts with continued response (Table 1). Similarly, the half-life estimated from the terminal slope of the cellular kinetic profile, an additional indicator of persistence, was higher in responding pts relative to non-responding pts for both DLBCL and ALL (Table 1). Despite this general trend, in some cases, transgene levels were not detectable at later time points in pts with continued response. The swimmer plot for representative responder ALL (Figure 1a) and DLBCL pts (Figure 1b) with responses and transgene levels demonstrate that although the majority of responding pts show persistent transgene levels, some pts maintained a favorable clinical response despite a decline in transgene levels to below the level of quantification of 50 copies/µg. Conclusion In both ALL and DLBCL, CAR transgene is initially detected at high levels with high variability in both responders and non-responders. While the majority of responding pts tend to have persistent transgene levels, some pts maintain favorable clinical responses despite a lack of quantifiable transgene. These results indicate that qPCR testing for CAR transgene in blood of tisagenlecleucel treated pts should not be used for making treatment decisions for individual pts. In addition, the qPCR measurements in peripheral blood do not reflect on the trafficking of CAR positive cells to sites outside peripheral blood. The assessment by flow cytometry remains an important assay to distinguish high expression in responding vs non-responding pts in ALL and CLL, and further evaluation of target tissue is needed in DLBCL to understand the utility of CAR expression as a means to distinguish responder and non-responders. Also, further data are needed to improve our understanding of how CAR transgene levels relate to disease burden and duration of response and whether this information is clinically useful. Disclosures Awasthi: Exelixis: Equity Ownership; Celgene: Equity Ownership; Novartis Institutes for Biomedical Research: Employment. Mueller:Novartis Institutes for Biomedical Research: Employment; Novartis Pharmaceuticals Corporation: Equity Ownership, Other: Patent pending. Tam:Abbvie: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Gilead: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; BeiGene: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Pharmacyclics: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Janssen: Consultancy, Honoraria, Research Funding. Rives:Amgen: Consultancy, Other: advisory board ; Novartis Pharmaceuticals Corporation: Consultancy, Other: Symposia, advisory boards ; Jazz Pharma: Consultancy, Other: Symposia, advisory boards ; Shire: Consultancy, Other: Symposia, advisory boards . McGuirk:Bellicum Pharmaceuticals: Research Funding; Fresenius Biotech: Research Funding; Novartis Pharmaceuticals Corporation: Honoraria, Other: speaker, Research Funding; Astellas Pharma: Research Funding; Gamida Cell: Research Funding; Kite Pharma: Honoraria, Other: travel accommodations, expenses, speaker ; Pluristem Ltd: Research Funding. Pulsipher:Adaptive Biotech: Consultancy, Research Funding; Amgen: Honoraria; CSL Behring: Consultancy; Novartis: Consultancy, Honoraria, Speakers Bureau. Jaeger:Roche: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Mundipharma: Membership on an entity's Board of Directors or advisory committees; Gilead: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; AbbVie: Consultancy, Honoraria; Takeda-Millenium: Membership on an entity's Board of Directors or advisory committees; Takeda-Millenium: Membership on an entity's Board of Directors or advisory committees; AOP Orphan: Membership on an entity's Board of Directors or advisory committees; Novartis: Membership on an entity's Board of Directors or advisory committees, Research Funding; Amgen: Membership on an entity's Board of Directors or advisory committees; Bioverativ: Membership on an entity's Board of Directors or advisory committees; Infinity: Membership on an entity's Board of Directors or advisory committees; GSK: Membership on an entity's Board of Directors or advisory committees; MSD: Research Funding; Celgene: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Janssen: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees. Baruchel:Novartis: Membership on an entity's Board of Directors or advisory committees; Shire: Research Funding; Jazz Pharmaceuticals: Consultancy, Honoraria, Other: Travel, accommodations or expenses; Amgen: Consultancy; Roche: Consultancy; Servier: Consultancy; Celgene: Consultancy. Myers:Novartis Pharmaceuticals Corporation: Consultancy, Honoraria, Research Funding, Speakers Bureau. Balke-Want:Novartis Pharmaceuticals Corporation: Honoraria. Schuster:Celgene: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Gilead: Membership on an entity's Board of Directors or advisory committees; Novartis Pharmaceuticals Corporation: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Merck: Consultancy, Honoraria, Research Funding; Dava Oncology: Consultancy, Honoraria; Nordic Nanovector: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Genentech: Honoraria, Research Funding. Stefanski:Novartis Pharmaceuticals Corporation: Consultancy, Honoraria, Speakers Bureau. Bishop:Novartis Pharmaceuticals Corporation: Speakers Bureau; Juneau Therapeutics: Speakers Bureau; Celgene: Honoraria, Speakers Bureau; Seattle Genetics: Consultancy, Membership on an entity's Board of Directors or advisory committees; United Healthcare: Employment. Waldron:Novartis Pharmaceuticals Corporation: Employment, Equity Ownership. Anak:Novartis Pharma AG: Employment. Chakraborty:Novartis Institutes for Biomedical Research: Employment. Bleickardt:Novartis Pharmaceuticals Corporation: Employment. Wong:Novartis Pharmaceuticals Corporation: Employment, Equity Ownership. Bubuteishvili Pacaud:Novartis Pharmaceuticals Corporation: Employment, Equity Ownership. Waller:Kalytera: Consultancy; Novartis Pharmaceuticals Corporation: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Celldex: Research Funding; Pharmacyclics: Other: Travel Expenses, EHA, Research Funding; Cambium Medical Technologies: Consultancy, Equity Ownership. Maude:Novartis Pharmaceuticals Corporation: Consultancy, Membership on an entity's Board of Directors or advisory committees.
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Ramos, Fernando, Marta Castellanos, Natalia De las Heras, Fernando Escalante, Silvia Fernandez-Ferrero, Maria Jesus Vidal, and Maria Lavinia Villalobos. "ECOG Performance Status Shows a Stronger Association with Treatment Tolerability Than Some Multidimensional Scales in Elderly Patients Diagnosed with Hematological Malignancies." Blood 136, Supplement 1 (November 5, 2020): 15–16. http://dx.doi.org/10.1182/blood-2020-136732.
Full textAbstract:
ECOG performance status (ECOG; Oken, 1982) is a unidimensional tool that does not measure independently patient general condition prior to diagnosis (Dx) and may modified by pre-phase therapy (Rx). Multidimensional evaluation of patient general condition is currently recommended by NCCN, ASCO and EORTC in elderly patients with cancer, commonly used as a predictor of life-expectancy and as a tool for detecting and palliate any underlying deficits. Treatment tolerability (TOL) can be predicted in patients with solid neoplasms by dedicated tools such as CARG (Hurria, 2011) and CRASH (Extermann, 2012), but they are not readily applicable to hematologic malignancies because these neoplasms, and the most commonly used therapeutic schemas in this group of diseases, have not been part of their clinical development. Our study aims to analyze the eventual association between TOL and the categories of commonly used multidimensional scales, such as the Geriatric Assessment in Hematology (GAH; Bonanad, 2015) and the Lee Index for Older Adults (LEE; Lee, 2006), in elderly patients receiving first-line immuno/chemotherapy. We have analyzed a prospective cohort of 182 adult patients diagnosed with hematologic malignancies in our center during the calendar year 2008. All patients gave written informed consent and the study was approved by our IRB. One hundred nine patients were older than 65 years and had their chart reviewed and general condition evaluated by ECOG, GAH and LEE (Table 1). Those aged 75 and over also received a Comprehensive Geriatric Assessment and were categorized as robust or non-robust. Seventy nine received immuno/chemotherapy (standard 53, attenuated 26) while 30 patients received only minimal Rx (supportive care or watch & wait). TOL was defined as the ability to receive Rx without modifications and measured by 2 composite endpoints: 'basic' and 'extended' TOL. Basic TOL included either: 1) dose reduction, 2) course delay, 3) drug elimination, or 4) Rx shortening/discontinuation not due to progressive disease; extended TOL also included 2 additional items, namely, 5) non-programmed hospital admission or 6) death during the first-line Rx. We followed standard statistical procedures including stepwise logistic regression, adjusting for 1) age (continuous), 2) gender, 3) diagnostic group, 4) physician, 5) prognostic subset (favorable, intermediate or unfavorable) specific for each diagnostic group, 6) ECOG (0-4) and 7) Rx type (standard vs attenuated). GAH and LEE scores were dichotomized following commonly used cutoffs in the clinic (GAH 0-42 vs 43-94; LEE 0-5 vs 6-26). Basic TOL was inadequate in 48.7%, and extended TOL in 64.5% of the patients (Table 2). We did not find any statistical association (Table 2) between basic/extended TOL and either GAH or LEE categories (cutoff 43 and 6, respectively). The only covariate that a statistically significant association to both basic and extended TOL was ECOG (Table 3). Multivariate analysis confirmed the association between ECOG and TOL (basic; p=0.05; extended, p=0.01) as well as the lack of association of TOL with GAH or LEE categories (Table 4). ROC analysis showed that ECOG score (0-4) explains 61% of the observed variability of basic TOL (AUC 95% CI 0.48-0.74) and 68% of extended TOL (AUC 95% CI 0.56-0.80). In addition, Comprehensive Geriatric Assessment stratification (robust vs non-robust) was not associated to TOL in the patients older than 75. In summary, we have observed no statistically significant association between treatment tolerability and the categories of Geriatric Assessment in Hematology or Lee Index for Older Adults. By contrary, ECOG was associated to that endpoints in the wide spectrum of hematologic malignancies. Disclosures Ramos: Celgene: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: travel and research grants; Novartis: Consultancy, Other: travel grant; Amgen: Consultancy, Other: travel grant; Abbvie: Consultancy, Other: travel grant; Jannsen: Other: travel grant; Roche: Other: travel grant; Rovi: Other: travel grant; Merck-Sahrp & Dohme: Other: travel grant; Daiichi-Sankyo: Other: travel grant; Takeda: Consultancy, Other: travel grant .
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Scuderi, Carla E., Suzanne L. Parker, Margaret Jacks, George John, Brett McWhinney, Jacobus Ungerer, Andrew Mallett, Jason A. Roberts, Helen Healy, and Christine E. Staatz. "Kidney transplant recipient’s perceptions of blood testing through microsampling and venepuncture." Bioanalysis 12, no. 13 (July 2020): 873–81. http://dx.doi.org/10.4155/bio-2020-0057.
Full textAbstract:
A survey of kidney transplant recipients receiving two innovative microsampling methods, dried blood spot and volumetric absorptive microsampling using patient reported methodology. A total of 39 adult transplant patients underwent venepuncture and finger prick-based blood draws on two occasions. They completed a survey of blood test understanding, tolerability, preferences and the burden associated with venepuncture compared with microsampling. A total of 85% of participants (n = 33) preferred finger prick-based sampling and 95% (n = 37) were interested in blood collection using self sampling by finger prick at home; 33% (n = 13) of participants experienced blood test anxiety. To quantify time burden of providing venous samples a total of 44% (n = 17) spent greater than 1 hour to travel and provide venous samples. This study observed a patient preference for microsampling for blood sampling as an alternative to venepuncture in the management of their kidney transplant.
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Alnazly, Eman Khamis. "Burden and Depression among Jordanian Caregivers of Hemodialysis Patients: A Cross-sectional Study." Open Nursing Journal 15, no. 1 (March 17, 2021): 29–37. http://dx.doi.org/10.2174/1874434602115010029.
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Introduction: Caring for patients receiving hemodialysis places a burden on caregivers. Objectives: To examine caregiving burden and depression in the family caregivers of patients receiving hemodialysis and associated factors. Methods: A cross-sectional design was used. Participants were 204 adult caregivers of patients receiving hemodialysis. Questionnaires included sociodemographic characteristics, the Oberst Caregiving Burden Scale-Difficulty (OCBS-D) subscale, Bakas Caregiving Outcomes Scale (BCOS), and the Patient Health Questionnaire-9 to measure the burden and depression of caregivers. Descriptive statistics, two linear regression analyses, and multinomial logistic regression were used in data analysis. Results: The majority (59.0%, n = 120) of caregivers had a moderate level of depression with scores ranging from 11 to 16. The analysis showed that the mean score of OCBS-D was 42.0 (SD = 4.7) with scores ranging from 26.9 to 58.9 (range = 32.0), while the caregivers' mean score of BCOS was 52.1 (SD = 9.3) with scores ranging from 38.0 to 82.5 (range = 44.5). Given that the expected score of OCBS-D and BCOS ranged from 15 to 75 and 15 to 105, respectively, the analysis indicated a moderate to a high level of burden among caregivers. Age and travel time were associated with a higher likelihood of negative outcomes in the family caregivers, while higher patient age was associated with a greater caregiver burden. Relevance to Clinical Practice: It is important to assess and address the practical issues that caregivers experience, such as employment-related responsibilities, financial difficulties, and the need to learn specific skills related to patients’ chronic illnesses. Conclusion: Caregivers of patients receiving hemodialysis are likely to experience moderate depression and burden. Caregiver burden increases with patient age and travel time to the hemodialysis units.
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Cheepsattayakorn, Attapon, and Ruangrong Cheepsattayakorn. "Parasitic Pneumonia and Lung Involvement." BioMed Research International 2014 (2014): 1–18. http://dx.doi.org/10.1155/2014/874021.
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Parasitic infestations demonstrated a decline in the past decade as a result of better hygiene practices and improved socioeconomic conditions. Nevertheless, global immigration, increased numbers of the immunocompromised people, international traveling, global warming, and rapid urbanization of the cities have increased the susceptibility of the world population to parasitic diseases. A number of new human parasites, such asPlasmodium knowlesi, in addition to many potential parasites, have urged the interest of scientific community. A broad spectrum of protozoal parasites frequently affects the respiratory system, particularly the lungs. The diagnosis of parasitic diseases of airway is challenging due to their wide varieties of clinical and roentgenographic presentations. So detailed interrogations of travel history to endemic areas are critical for clinicians or pulmonologists to manage this entity. The migrating adult worms can cause mechanical airway obstruction, while the larvae can cause airway inflammation. This paper provides a comprehensive review of both protozoal and helminthic infestations that affect the airway system, particularly the lungs, including clinical and roentgenographic presentations, diagnostic tests, and therapeutic approaches.
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Jongman, E. C., M. K. Edge, K. L. Butler, and G. M. Cronin. "Reduced space allowance for adult sheep in lairage for 24hours limits lying behaviour but not drinking behaviour." Australian Journal of Experimental Agriculture 48, no. 7 (2008): 1048. http://dx.doi.org/10.1071/ea08039.
Full textAbstract:
The key lairage requirements for livestock include sufficient space to lie down, sufficient time to allow recovery from travel, and access to water to allow recovery from dehydration. Current recommendations for lairage of adult sheep include that holding pens should provide no less space than 0.6 m2 per sheep. Particularly during periods when large numbers of sheep are culled, space allowances may be limited to 0.3 m2 or less, which may reduce the ability of individual sheep to lie down or access water. Adult Merino-cross sheep were allocated to one of four space allowance treatments during unloading from commercial transport vehicles at a commercial abattoir after an average transport time of 3 h. The treatments were 0.3, 0.45, 0.6 and 1.0 m2/sheep and each pen measured 18 m2. Differences in space allowance were achieved by varying the number of sheep per pen, with pens holding 18 (1 m2), 30 (0.6 m2), 40 (0.45 m2) and 60 (0.3 m2) animals. In each pen, eight focal sheep were randomly selected and marked on the back for identification on video records. The sheep remained in the lairage treatments for 24 h and were continuously recorded on video using low light cameras. The data were subsequently analysed for both lying and drinking behaviours after 8 and 24 h in lairage. There were five replicates of all treatments over a 3-week period. A space allowance of 0.3 m2/sheep reduced the time sheep spent lying and the proportion of sheep that lay down at least once, compared with greater space allowances. Space allowances between 0.3 and 1 m2/sheep showed a linear relationship with the time sheep spent lying during the first 24 h. Optimal space allowance may be greater than 1 m2, based on lying behaviour. Drinking behaviour was not affected by space allowance in a 24 h period in lairage although overall 20% of sheep were not observed to drink after 24 h in lairage.
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Hoffmann, Verena Sophia, Michele Baccarani, Joerg Hasford, Doris Lindoerfer, Sonja Burgstaller, Dubravka Sertic, Paul Costeas, et al. "Treatment and Outcome Analysis of 2,904 Pateints from the EUTOS Population Based Registry." Blood 126, no. 23 (December 3, 2015): 2780. http://dx.doi.org/10.1182/blood.v126.23.2780.2780.
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Abstract Introduction Clinical studies clearly show that treatment with tyrosine-kinase inhibitors (TKI) greatly improve the prognosis of patients with CML. Detailed treatment recommendations have since been deduced from clinical trial results by the European LeukemiaNet (Blood 122:872-884). However, little is known about whether these achievements can also be transferred to routine health care. This work investigates if all CML patients are treated in agreement with current standards and wether they achieve outcomes at least as good as those in clinical trials. Methods The web-based registry aimed to collect all newly diagnosed adult patients with chronic phase Ph+ and/or BCR-ABL1+ CML in 20 countries or pre-specified regions covering ~ 92.5 million inhabitants. Overall 2904 patients were registered between 2008 and 2012. Cytogenetic and molecular responses were analyzed using cumulative incidences considering death and progression as competing risks. Survival was analyzed using Kaplan-Meier curves and log rank tests. Results 2342 patients were diagnosed in chronic phase and had follow-up data available. The median age was 55 years (range: 18 to 99 years) and 53% were male; 11% of the patients were at high risk of not achieving complete cytogenetic remission (CCyR) at 18 months according to the EUTOS score. According to the Euro score 10% of the patients were in the high risk group, 51% in the intermediate and 39% in the low risk group. 18% were included in clinical trials. Treatment data of 1701 patients were contributed from 15 countries (85% of 2042 patients registered in those countries). As a first-line therapy 80% of patients received imatinib 15% nilotinib, 3% dasatinib and 3% hydroxyurea (HU). Of the patients receiving nilotinib or dasatinib 56% had been enrolled into clinical trials. There were no significant differences between female and male patients regarding the first-line therapy. More than half of the patients who were treated with HU alone were aged 70 or older. Time to first CCyR is known for 62% of patients. Median time to first CCyR was 10 months; after 12 months 57% (95% CI 54%-60%) and after 18 months 76% (95% CI 74%-79%) had achieved CCyR. Time to first CCyR differed significantly regarding the EUTOS score. Median time to first CCyR was 9 months for the low and 13 months for the EUTOS high risk group (p < 0.0001). After 18 months 78% (95% CI 75%-80%) of patients in the low and 69% (95% CI 60%-76%) of patients in the high risk group had achieved CCyR. The patients' age did not have major influence on the time to first CCyR (p=0.8974, median time to first CCyR: 18 to 39 years: 9 months, 40-65 years: 9 months, older than 65 years: 11 months). Time to first major molecular remission (MMR) could be calculated for 54% of patients. Median time to first MMR was 15 months. Cumulative incidence of MMR after 12 months was 41% (95% CI 38%- 44%). The median observation time of living patients was 29 months. 187 patients died (8%). Probability of OS for all patients at 12, 24 and 30 months was 97% (95% CI 96% - 97%), 94% (95% CI 93% - 95%) and 92% (95% CI 90% - 93%), respectively. 108 patients progressed of whom 62 subsequently died, while 125 patients died without prior progression. Probability of PFS for all patients at 12, 24 and 30 months was 95% (95% CI 94% - 96%), 92% (95% CI 91% - 93%) and 90% (95% CI 88% - 91%), respectively. Of the 187 patients who died, 33% died after progression. 67% died without prior progression. The probability of progression and subsequent death was 1% (95% CI 1% - 2%) after 12 months and 2% (95% CI 2% - 3%) after 24 months. The probability of dying without prior progression was 2% (95% CI 2% - 96%) after 12 months and 4% (95% CI 3% - 5%) after 24 months. Discussion The EUTOS population based registry provides the first unselected sample of adult Ph+ and/or BCR/ABL1+ adult CML patients in Europe. It shows that in Europe the success reported from commercial and academic studies is transferred to the general population. The majority of patients were treated first-line with imatinib, which was the only TKI approved for first-line use by the EMA during most of the registration period. Probabilities of PFS and OS in the registry are comparable to those in clinical trials. The importance of calculating both overall survival and leukemia-related survival is highlighted, since many patients die from different causes related or unrelated to leukemia and to treatment, but without progression. Disclosures Hoffmann: Novartis Oncology Europe: Research Funding. Baccarani:PFIZER: Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Bristol-Myers Squibb: Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; ARIAD Pharmaceuticals, Inc.: Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; NOVARTIS: Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. Hasford:Novartis: Research Funding. Lindoerfer:Novartis Oncology Europe: Research Funding. Burgstaller:Novartis: Honoraria; Mundipharma: Honoraria; Celgene: Consultancy, Honoraria, Research Funding; AOP Orphan Pharmaceuticals: Honoraria, Research Funding. Mayer:Novartis: Consultancy, Other: funding of travel, accomodations or expenses, Research Funding; BMS: Consultancy, Other: funding of travel, accomodations or expenses, Research Funding. Koskenvesa:GSK: Consultancy; Pfizer: Consultancy; Ariad: Other: funding of travel, accomodations or expenses; BMS: Consultancy, Other: funding of travel, accomodations or expenses; Novartis: Consultancy, Research Funding. Castagnetti:Novartis: Consultancy, Honoraria; BMS: Consultancy, Honoraria; Pfizer: Consultancy, Honoraria; ARIAD: Consultancy, Honoraria. Griskevicius:Novartis: Consultancy, Research Funding; Baxalta: Research Funding. Sacha:Angelini: Consultancy; Adamed: Consultancy; Novartis: Consultancy; BMS: Consultancy. Hellmann:Novartis: Consultancy, Other: funding of travel, accomodations or expenses, Research Funding, Speakers Bureau; BMS: Consultancy, Other: funding of travel, accomodations or expenses, Speakers Bureau. Turkina:Pfizer: Consultancy; Bristol Myers Squibb: Consultancy; Novartis Pharma: Consultancy. Zaritskey:University of Heidelberg: Research Funding; Novartis: Consultancy. Sninska:Novartis: Consultancy. Simonsson:Novartis Pharma: Research Funding. Saussele:Novartis Pharma: Honoraria, Other: Travel grant, Research Funding; ARIAD: Honoraria; Pfizer: Honoraria, Other: Travel grant; BMS: Honoraria, Other: Travel grant, Research Funding. Hochhaus:ARIAD: Honoraria, Research Funding; Pfizer: Honoraria, Research Funding; Bristol-Myers Squibb: Honoraria, Research Funding; Novartis: Honoraria, Research Funding. Hehlmann:BMS: Consultancy; Novartis Pharma: Research Funding.
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Dakwar, Elias, Fernando L. Vale, and Juan S. Uribe. "Trajectory of the main sensory and motor branches of the lumbar plexus outside the psoas muscle related to the lateral retroperitoneal transpsoas approach." Journal of Neurosurgery: Spine 14, no. 2 (February 2011): 290–95. http://dx.doi.org/10.3171/2010.10.spine10395.
Full textAbstract:
Object The minimally invasive lateral retroperitoneal transpsoas approach is increasingly used to treat various spinal disorders. Accessing the retroperitoneal space and traversing the abdominal wall poses a risk of injury to the major nervous structures and adds significant morbidity to the procedure. Most of the current literature focuses on the anatomy of the lumbar plexus within the substance of the psoas muscle. However, there is sparse knowledge regarding the trajectory of the lumbar plexus nerves that travel along the retroperitoneum and abdominal wall muscles in relation to the lateral approach to the spine. The objective of this study is to define the anatomical trajectories of the major motor and sensory branches of the lumbar plexus that are located outside the psoas muscle. Methods Six adult fresh frozen cadaveric specimens were dissected and studied (12 sides). The relationship between the retroperitoneum, abdominal wall muscles, and the lumbar plexus nerves was analyzed in reference to the minimally invasive lateral retroperitoneal approach. Special attention was given to the lumbar plexus nerves that run outside of psoas muscle in the retroperitoneal cavity and within the abdominal muscle wall. Results The skin and muscles of the abdominal wall and the retroperitoneal cavity were dissected and analyzed with respect to the major motor and sensory branches of the lumbar plexus. The authors identified 4 nerves at risk during the lateral approach to the spine: subcostal, iliohypogastric, ilioinguinal, and lateral femoral cutaneous nerves. The anatomical trajectory of each of these nerves is described starting from the spinal column until their termination or exit from the pelvic cavity. Conclusions There is risk of direct injury to the main motor/sensory nerves that supply the anterior abdominal muscles during the early stages of the lateral retroperitoneal transpsoas approach while obtaining access to the retroperitoneum. There is also a risk of injury to the ilioinguinal, iliohypogastric, and lateral femoral cutaneous nerves in the retroperitoneal space where they travel obliquely during the blunt retroperitoneal dissection. Moreover, there is a latent possibility of lesioning these nerves with the retractor blades against the anterior iliac crest.
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James, Michael C., Ransom A. Myers, and C. Andrea Ottensmeyer. "Behaviour of leatherback sea turtles, Dermochelys coriacea , during the migratory cycle." Proceedings of the Royal Society B: Biological Sciences 272, no. 1572 (July 11, 2005): 1547–55. http://dx.doi.org/10.1098/rspb.2005.3110.
Full textAbstract:
Leatherback sea turtles, Dermochelys coriacea , undertake broad oceanic movements. While satellite telemetry has been used to investigate the post-nesting behaviour of female turtles tagged on tropical nesting beaches, long-term behavioural patterns of turtles of different sexes and sizes have not been described. Here we investigate behaviour for 25 subadult and adult male and female turtles satellite-tagged in temperate waters off Nova Scotia, Canada. Although sex and reproductive condition contributed to variation in migratory patterns, the migratory cycle of all turtles included movement between temperate and tropical waters. Marked changes in rates of travel, and diving and surfacing behaviour, accompanied southward movement away from northern foraging areas. As turtles approached higher latitudes the following spring and summer, they assumed behaviours consistent with regular foraging activity and eventually settled in coastal areas off Canada and the northeastern USA. Behavioural patterns corresponding to various phases of the migratory cycle were consistent across multiple animals and were repeated within individuals that completed return movements to northern waters. We consider the potential biological significance of these patterns, including how turtle behaviour relates to predator avoidance, thermoregulation and prey distribution.
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Hindell, MA, DJ Slip, and HR Burton. "The Diving Behavior of Adult Male and Female Southern Elephant Seals, Mirounga-Leonina (Pinnipedia, Phocidae)." Australian Journal of Zoology 39, no. 5 (1991): 595. http://dx.doi.org/10.1071/zo9910595.
Full textAbstract:
Over 50 000 individual dive records collected by time-depth recorders were analysed with respect to sex of the seal, time of year and the approximate geographic location of the dive. Six distinct dive types were described on the basis of parameters such as the amount of time spent at the maximum depth of the dive, the rate of ascent and descent, and the general form of the dive profile. These dive types were 'rest' dives, 'travel' dives, 'surface' dives, 'general non-foraging' dives, 'pelagic foraging' dives and 'benthic foraging' dives. The seals spent 90% of their time at sea submerged. Less than 2% of the time was spent on the surface in intervals of more than 10 min. A further 20-30% of the time was spent on the various non-foraging types of dives. Most females performed only 'pelagic foraging' dives, while males performed both 'pelagic' and 'benthic foraging' dives. All the 'benthic foraging' dives occurred in Area 3 (defined by water-temperature data as lying over the Antarctic Continental Shelf) and were 400-500 m deep. 'Pelagic foraging' dives occurred in all three foraging areas and ranged in depth from 200 to 1100 m. These types of dives also exhibited marked diurnal variations in depth, unlike 'benthic foraging' dives. The seals spent 10-20 min at the bottom of each 'foraging' dive, where they generally displayed a series of small changes in depth (wiggles). The size of these 'wiggles' tended to be larger in 'pelagic foraging' dives than in 'benthic foraging' dives. The diving behaviour of southern elephant seals is related to the possible prey they exploit in the Southern Ocean.
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Morais, S., J. Silva Ribeiro, P. Oliveira, E. Mendes, A. Botelho, H. Godinho, L. Vale, et al. "Substance use among youth psychiatric outpatients." European Psychiatry 41, S1 (April 2017): s871. http://dx.doi.org/10.1016/j.eurpsy.2017.01.1750.
Full textAbstract:
IntroductionPortuguese young adults (15–34 years old) were more frequent engaged in substance abuse (1.2%) than the general population, according to the Portuguese substance use annual report (2014). Alcohol was the most frequent substance use on youth adults. Cannabis was the most frequent illicit substance used (23.9% of users were considered dependent), with higher prevalence than previously reported. LSD (0.4%) use was also higher among young adults than in previous studies. Cocaine (0.4%), heroine/opiates (0.4%), ecstasy (0.3%), and hallucinogenic mushrooms (1.1%) had their consumption lowered among young adults.Objectives/aimsTo characterize a population of young adult psychiatric outpatients, regarding substance use and associated risk.MethodsSocio-demographic characterization of our young adult unit outpatient users between 1st January 2015–31st July 2016. Substance use was assessed with the Portuguese version of Alcohol, Smoking and Substance Involvement Screening Test (ASSIST).ResultsA total of 255 outpatients were observed during the timeframe; 58 outpatients were assessed with ASSIST: 44 females (75.9%) and 14 males (24.1%), aged between 16–33 years old (average: 20.95; median: 19.50). For tobacco, 3.5% had high risk, 37.9% moderate risk and 58.6% low risk; 22.4% had moderate risk of alcohol, 13.8% moderate risk of cannabis, and 20.7% moderate risk of tranquilizers. For others substances (cocaine, stimulants, inhalants, hallucinogens, and opiates) the risk was low.ConclusionsIn our sample, alcohol and cannabis use had the highest risk, as reported in the National Annual Report; however, we observed a moderate risk for tranquilizers use. In future care planning, youth mental health should address tobacco and alcohol abstinence, and preventive measures regarding anxiolytics should be undertaken, such as banning sale without medical prescription.Disclosure of interestThe authors have not supplied their declaration of competing interest.