Dietary restriction (DR) is the most powerful intervention to enhance health and lifespan across species. However, recent findings indicate that DR started in late life has limited capacity to induce ...health benefits. Age-dependent changes that impair DR at old age remain to be delineated. This requires a better mechanistic understanding of the different aspects that constitute DR, how they act independently and in concert. Current research efforts aim to tackle these questions: Are fasting periods needed for the induction of DR's health benefits? Does the improvement of cellular and organismal functions depend on the reduction of specific dietary components like proteins or even micronutrients and/or vitamins? How is the aging process intervening with DR-mediated responses? Understanding the evolutionary benefits of nutrient stress responses in driving molecular and cellular adaptation in response to nutrient deprivation is likely providing answers to some of these questions. Cellular memory of early life may lead to post-reproductive distortions of gene regulatory networks and metabolic pathways that inhibit DR-induced stress responses and health benefits when the intervention is started at old age. Inhere we discuss new insights into mechanisms of DR-mediated health benefits and how evolutionary selection for fitness in early life may limit DR-mediated improvements at old age.
Background
Surgery for catecholamine‐producing tumours can be complicated by intraoperative and postoperative haemodynamic instability. Several perioperative management strategies have emerged but ...none has been evaluated in randomized trials. To assess this issue, contemporary perioperative management and outcome data from 21 centres were collected.
Methods
Twenty‐one centres contributed outcome data from patients who had surgery for phaeochromocytoma and paraganglioma between 2000 and 2017. The data included the number of patients with and without α‐receptor blockade, surgical and anaesthetic techniques, complications and perioperative mortality.
Results
Across all centres, data were reported on 1860 patients with phaeochromocytoma or paraganglioma, of whom 343 underwent surgery without α‐receptor blockade. The majority of operations (78·9 per cent) were performed using minimally invasive techniques, including 16·1 per cent adrenal cortex‐sparing procedures. The cardiovascular complication rate was 5·0 per cent overall: 5·9 per cent (90 of 1517) in patients with preoperative α‐receptor blockade and 0·9 per cent (3 of 343) among patients without α‐receptor blockade. The mortality rate was 0·5 per cent overall (9 of 1860): 0·5 per cent (8 of 517) in pretreated and 0·3 per cent (1 of 343) in non‐pretreated patients.
Conclusion
There is substantial variability in the perioperative management of catecholamine‐producing tumours, yet the overall complication rate is low. Further studies are needed to better define the optimal management approach, and reappraisal of international perioperative guidelines appears desirable.
Antecedentes
La cirugía de los tumores productores de catecolaminas puede complicarse por la inestabilidad hemodinámica intraoperatoria y postoperatoria. Se han propuesto distintas estrategias de manejo perioperatorio, pero ninguna ha sido evaluada en ensayos aleatorizados. Para evaluar este tema, se han recogido los datos de los resultados y del manejo perioperatorio contemporáneo de 21 centros.
Métodos
Veintiún centros aportaron datos de los resultados de los pacientes operados por feocromocitoma y paraganglioma entre 2000‐2017. Los datos incluyeron el número de pacientes con y sin bloqueo del receptor α, las técnicas quirúrgicas y anestésicas, las complicaciones y la mortalidad perioperatoria.
Resultados
Los centros en su conjunto aportaron datos de 1.860 pacientes con feocromocitoma y paraganglioma, de los cuales 343 pacientes fueron intervenidos sin bloqueo del receptor α. La gran mayoría (79%) de las cirugías se realizaron utilizando técnicas mínimamente invasivas, incluido un 17% de procedimientos con preservación de la corteza suprarrenal. La tasa de complicaciones cardiovasculares fue de 5,0% en total; 5,9% (90/1517) en pacientes con bloqueo preoperatorio de los receptores α y 0,9% (3/343) en pacientes no pretratados. La mortalidad global fue del 0,5% (9/1860); 0,5% (8/1517) en pacientes pretratados y 0,3% (1/343) en pacientes no tratados previamente.
Conclusión
Existe una variabilidad sustancial en el manejo perioperatorio de los tumores productores de catecolaminas, aunque la tasa global de complicaciones es baja. Este estudio brinda la oportunidad para efectuar comparaciones sistemáticas entre estrategias de prácticas terapéuticas variables. Se necesitan más estudios para definir mejor el enfoque de manejo óptimo y parece conveniente volver a evaluar las guías internacionales perioperatorias.
Morbidity and mortality rates are difficult to determine in rare diseases like phaeochromocytoma. To date there has been no randomized study of the perioperative management of these patients. Therefore, an international and interdisciplinary effort was made to provide a broad overview of the current management of phaeochromocytoma.
Adverse effects frequent with preoperative blocking
The relevance of care of older persons in general practice requires the conveyance of procedural and conditional knowledge of the geriatric basic assessment (GBA) even during medical studies. There ...is a need for action with respect to student knowledge on specific problems of older patients. This paper describes how the primary care situation can be made tangible for students based on a film project at the Hannover Medical School (MHH).
During film production, strategies for creating authenticity were applied using cinematic means. The film is used in the teaching module of family medicine at MHH. Student evaluation investigated whether the educational film provided an emotional experience and whether the presentation mode of the GBA was perceived as authentic.
The majority of students were emotionally touched by the film. The educational film was successful in conveying the complexity of care of older people and in presenting the special role of family physicians in geriatric care.
The students recognized the necessity of the GBA and found the representation predominantly realistic; however, individual cinematic reception and previous experiences also influence the perception of the cinematic form with respect to the representation of reality. This method might improve the conveyance of authenticity in educational videos in medicine.
Relationships of temperament evaluated at different production stages with growth, carcass characteristics and beef tenderness were determined in Bonsmara crossbred steers managed under commercial ...managent. Temperament was evaluated at weaning and at initiation of the finishing phase. Steers from a Roswell, NM ranch (
n
=
156) and a Cline, TX ranch (
n
=
21) were stratified at fall weaning by weight and source and randomly allotted to winter ryegrass at Uvalde or Overton, TX followed by feeding in a commercial feedlot near Batesville, TX. Cattle were observed for temperament (escape velocity, EV, m/s; pen and chute temperament score, PTS and CTS) at weaning and upon entry to the feedlot. Cattle were harvested at approximately 7 mm 12th rib fat. Carcass data was taken approximately 36 hrs post-mortem and 2.5
cm thick steaks were removed from the 13th rib for Warner–Bratzler shear force (WBS) determination. The only measures of temperament significantly related to performance were EV and PTS. Weaning EV appeared to be more related to feedlot ADG (
r
=
−0.26,
P
<
0.003), ribeye area (
r
=
−0.37,
P
<
0.0008), yield grade (
r
=
0.29,
P
<
0.01) and WBS,
r
=
0.27,
P
<
0.005) than did the later measures of temperament. However, in-feedlot EV was associated with feedlot weights (
r
=
−0.28,
P
<
0.0004). Results of this research suggest temperament, particularly at weaning, is related to feedlot performance, carcass merit, and beef tenderness at a low to moderate level and evaluation of this trait may be a helpful management tool.
Open educational resources (OER) are educational materials licensed openly by authors, permitting usage, redistribution, and in some instances, modification. OER platforms thereby serve as a medium ...for distributing and advancing teaching materials and innovative educational methodologies.
This study aims to determine the present state of OER in otorhinolaryngology and to examine the prerequisites for seamlessly integrating OER into the curricular teaching of medical schools, specifically through the design of two OER blended learning modules.
OER content in the field of otorhinolaryngology was analyzed on OER platforms, ensuring its relevance to the German medical curriculum. Data protection concerns were addressed with legal counsel. The blended learning modules were developed in collaboration with medical students and subsequently published as OER.
This project yielded the first OER from a German ENT department, tailored to the German medical curriculum. One significant barrier to OER use in medicine, more than in other fields, is data protection. This challenge can be navigated by obtaining consent to publish patient data as OER. OER hold the promise to play a pivotal role in fostering cooperation and collaboration among educators, aiding educators in lesson preparation, and simultaneously enhancing didactic quality.
A randomized complete block design with 3 replications (n = 432, 72 broilers per treatment) was used to evaluate the effects of electrical (ES) and vacuum stunning (VS) on broiler breast meat ...quality. Electrical stunning was performed by applying 11.5 V, <0.05 mA, AC to DC current for 3 s for each broiler. Vacuum stunning was accomplished by exposing the birds to a low atmospheric pressure of 597 to 632 mmHg in an airtight decompression chamber. Breast removal was then performed at 0.75, 2, and 4 h postmortem for each stunning method. Color, pH, cook loss, and shear force values were measured on breasts that were removed from the right side of the carcass. Breasts removed from the left side of the carcass were used for consumer acceptability testing. The L* values were lower (P < 0.05) for VS than ES at 4-and 2-h deboning times. On average, 15-min and 24-h postmortem pH values were not different (P > 0.05) for both stunning method and deboning time. Shear force did not differ (P > 0.05) between stunning methods but decreased (P < 0.05) as deboning time increased. On average, no differences (P > 0.05) existed in consumer acceptability (appearance, texture, flavor, overall) among breast meat from ES or VS birds that were deboned at 2 or 4 h. However, consumers could be clustered into 8 groups based on preference and liking of samples regarding overall and texture acceptability. Sixty-five percent of consumers (3 clusters) liked all broiler breast treatments. Within these 3 clusters, some consumers preferred (P < 0.05) 4-h deboned samples over those deboned at 2 h (cluster 7), and other consumers preferred (P < 0.05) those deboned at 2 h over 4-h samples (cluster 6). Data revealed that both stunning methods provided high-quality breast meat with minimal product differences.
Abstract Purpose Due to the time factor in polytraumatized patients all relevant pathologies in a polytrauma computed tomography (CT) scan have to be read and communicated very quickly. During ...radiology residency acquisition of effective reading schemes based on typical polytrauma pathologies is very important. Thus, an online tutorial for the structured diagnosis of polytrauma CT was developed. Materials and methods Based on current multimedia theories like the cognitive load theory a didactic concept was developed. As a web-environment the learning management system ILIAS was chosen. CT data sets were converted into online scrollable QuickTime movies. Audiovisual tutorial movies with guided image analyses by a consultant radiologist were recorded. Results The polytrauma tutorial consists of chapterized text content and embedded interactive scrollable CT data sets. Selected trauma pathologies are demonstrated to the user by guiding tutor movies. Basic reading schemes are communicated with the help of detailed commented movies of normal data sets. Common and important pathologies could be explored in a self-directed manner. Conclusions Ambitious didactic concepts can be supported by a web based application on the basis of cognitive load theory and currently available software tools.
Consumers (n=316) were recruited from college football picnickers to select ribeye, sirloin, and top loin steaks from 3 price groups based on thickness (n=10 steaks per price/type combination). ...Constant weight steaks were assigned to these groups: P1, thinnest, $19.80/kg ribeye and top loin, $10.99/kg sirloin; P2, average thickness, $22.00/kg ribeye and top loin, $13.19/kg sirloin; P3, thickest, $24.21/kg ribeye and top loin, $15.40/kg sirloin. Consumers selected 3 steaks per type and ranked selection criteria (price, color, marbling, thickness, texture). Percentage of steaks chosen from each price group did not differ (P>0.05), but consumers tended to select thinner ribeye steaks (P1 and P2) and thicker sirloin steaks (P2 and P3). Across all steak types, a greater number of consumers reported that marbling, color, and thickness were more important than price and visual texture. Data indicate that consumers may select steaks that display their preferred attributes, even if the steaks cost more.
► We examine consumer selection of beef that is priced based on thickness of steak. ► Consumers indicated marbling, color, and thickness were more important than price. ► Consumers select steaks based on preferred attributes rather than price. ► Improving sorting and marketing may allow for premium pricing.
Goat loins (n=22) were evaluated to test effects of 0, 15, and 30% dietary pine bark (PB) and salt, water, and phosphate enhancement on shelf-life, shear force (WBSF) and consumer acceptability. No ...interactions existed between PB and enhancement. Dietary PB did not affect objective color, but enhancement increased a* and b* values (P<0.05). Thiobarbituric acid reactive substances (TBARS) increased from d 1 to d 5 of storage (P<0.0001), but were not affected by PB or enhancement. The WBSF for 30% PB was less than that of 0% PB (P=0.0199), and enhancement decreased WBSF (P=0.0010). Texture, flavor, and overall acceptability were greater (P<0.05) for 15 and 30% PB compared to 0% PB. Enhanced loin samples had greater appearance, aroma, texture, flavor, and overall acceptability scores (P<0.05). Results indicated that enhancement improved tenderness and consumer acceptability of goat loin, and PB had minimal impact on goat loin quality.
► Enhanced loins from goats fed pine bark evaluated for shelf-life and palatability. ► Dietary pine bark had minimal effects on consumer liking or shelf-life of chevon. ► Salt and phosphate improved consumer liking of goat meat. ► Value-added processing may benefit the goat meat industry.
Constant-weight ribeye, top loin, and sirloin steaks were collected from beef carcasses (n
=
25) representing five weight/loin muscle area (LMA) groups: G1 (226.8–271.7
kg; 70.97–78.96
cm
2), G2 ...(272.2–317.1
kg; 78.71–85.81
cm
2), G3 (317.5–362.4
kg; 86.45–93.55
cm
2), G4 (362.9–407.8
kg; 800
cwt, 94.19–101.29
cm
2), and G5 (408.2–453.1
kg; 101.94–109.03
cm
2). Consumers (n
=
316) selected 3 steaks of each type and ranked selection criteria (color, marbling, thickness, texture). Consumers selected ribeye steaks from G5 most frequently (
P
=
0.0002), but there were no differences among HCW/LMA groups for top loin or sirloin steaks. Thickness was the primary criterion for sirloins and top loins, but marbling was the primary criterion for ribeyes. Data indicate that consumers have preferences for steak thickness and appearance, but the preferred characteristics differ among consumers.
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