In recent years increasing evidence has emerged suggesting that oxidative stress is involved in the pathophysiology of a number of inherited metabolic disorders. However the clinical use of classical ...antioxidants in these diseases has been poorly evaluated and so far no benefit has been demonstrated. l-Carnitine is an endogenous substance that acts as a carrier for fatty acids across the inner mitochondrial membrane necessary for subsequent beta-oxidation and ATP production. Besides its important role in the metabolism of lipids, l-carnitine is also a potent antioxidant (free radical scavenger) and thus may protect tissues from oxidative damage. This review addresses recent findings obtained from patients with some inherited neurometabolic diseases showing that l-carnitine may be involved in the reduction of oxidative damage observed in these disorders. For some of these diseases, reduced concentrations of l-carnitine may occur due to the combination of this compound to the accumulating toxic metabolites, especially organic acids, or as a result of protein restricted diets. Thus, l-carnitine supplementation may be useful not only to prevent tissue deficiency of this element, but also to avoid oxidative damage secondary to increased production of reactive species in these diseases. Considering the ability of l-carnitine to easily cross the blood–brain barrier, l-carnitine supplementation may also be beneficial in preventing neurological damage derived from oxidative injury. However further studies are required to better explore this potential.
•Oxidative stress has been highly demonstrated in neurometabolic disorders.•Carnitine deficiency can cause deleterious effects in the CNS.•Carnitine is a promising antioxidant in the treatment of neurometabolic disorders.
Background and Aims
Increased alcohol consumption has been proposed as a potential consequence of the coronavirus disease 2019 (COVID‐19) pandemic. There has been little scrutiny of alcohol use ...behaviors resulting in hospital visits, which is essential to guide pandemic public policy. We aimed to determine whether COVID‐19 peak restrictions were associated with increased hospital visits for alcohol use or withdrawal. Secondary objectives were to describe differences based on age, sex and race, and to examine alcohol‐related complication incidence.
Design
Multi‐center, retrospective, pre–post study.
Setting
New York City health system with five participating hospitals.
Participants
Adult emergency department encounters for alcohol use, alcoholic gastritis or pancreatitis or hepatitis, alcohol withdrawal syndrome, withdrawal seizure or delirium tremens.
Measurements
Age, sex, race, site and encounter diagnosis. Encounters were compared between 2019 and 2020 for 1 March to 31 May.
Findings
There were 2790 alcohol‐related visits during the 2019 study period and 1793 in 2020, with a decrease in total hospital visits. Of 4583 alcohol‐related visits, median age was 47 years, with 22.3% females. In 2020 there was an increase in percentage of visits for alcohol withdrawal adjusted odds ratio (aOR) = 1.34, 95% confidence interval (CI) = 1.07–1.67 and withdrawal with complications (aOR = 1.40, 95% CI = 1.14–1.72), and a decline in percentage of hospital visits for alcohol use (aOR = 0.70, 95% CI = 0.59–0.85) and use with complications (aOR = 0.71, 95% CI = 0.58–0.88). It is unknown whether use visit changes mirror declines in other chief complaints. The age groups 18–29 and 60–69 years were associated with increased visits for use and decreased visits for withdrawal, as were non‐white race groups. Sex was not associated with alcohol‐related visit changes despite male predominance.
Conclusions
In New York City during the initial COVID‐19 peak (1 March to 31 May 2020), hospital visits for alcohol withdrawal increased while those for alcohol use decreased.
Co-creation of healthy food retail comprises the systematic collaboration between retailers, academics and other stakeholders to improve the healthiness of food retail environments. Research into the ...co-creation of healthy food retail is in its early stages. Knowledge of the roles and motivations of stakeholders in intervention design, implementation and evaluation can inform successful co-creation initiatives. This study presents academic experiences of stakeholder roles and motivations in the co-creation of healthy food retail environments.
Purposive sampling of academics with research experience in the co-creation of healthy food retail initiatives. Semi-structured interviews conducted between October and December 2021 gathered participants' experiences of multi-stakeholder collaborative research. Thematic analysis identified enablers, barriers, motivations, lessons and considerations for future co-creation of healthy food retail.
Nine interviewees provided diverse views and applications of co-creation research in food retail environments. Ten themes were grouped into three overarching areas: (i) identification of stakeholders required for changes to healthier food retail; (ii) motivations and interactions, which included the intrinsic desire to build healthier communities along with recognition of their work; and (iii) barriers and enablers included adequate resourcing, effective and trusting working relationships and open communications.
This study provides insights that could help future co-creation in healthy food retail environments. Trusting and respectful relationships and reciprocal acknowledgement between stakeholders are key practices in the co-creation process. These constructs should be considered in developing and testing a model that helps to systematically co-create healthy food retail initiatives that ensure all parties meet their needs while also delivering research outcomes.
Objectives
To examine the effect of an emergency department (ED)‐based transitional care nurse (TCN) on hospital use.
Design
Prospective observational cohort.
Setting
Three U.S. (NY, IL, NJ) EDs from ...January 1, 2013, to June 30, 2015.
Participants
Individuals aged 65 and older in the ED (N = 57,287).
Intervention
The intervention was first TCN contact. Controls never saw a TCN during the study period.
Measurements
We examined sociodemographic and clinical characteristics associated with TCN use and outcomes. The primary outcome was inpatient admission during the index ED visit (admission on Day 0). Secondary outcomes included cumulative 30‐day admission (any admission on Days 0–30) and 72‐hour ED revisits.
Results
A TCN saw 5,930 (10%) individuals, 42% of whom were admitted. After accounting for observed selection bias using entropy balance, results showed that when compared to controls, TCN contact was associated with lower risk of admission (site 1: −9.9% risk of inpatient admission, 95% confidence interval (CI) = −12.3% to −7.5%; site 2: −16.5%, 95% CI = −18.7% to −14.2%; site 3: −4.7%, 95% CI = −7.5% to −2.0%). Participants with TCN contact had greater risk of a 72‐hour ED revisit at two sites (site 1: 1.5%, 95% CI = 0.7–2.3%; site 2: 1.4%, 95% CI = 0.7–2.1%). Risk of any admission within 30 days of the index ED visit also remained lower for TCN patients at both these sites (site 1: −7.8%, 95% CI = −10.3% to −5.3%; site 2: −13.8%, 95% CI = −16.1% to −11.6%).
Conclusion
Targeted evaluation by geriatric ED transitions of care staff may be an effective delivery innovation to reduce risk of inpatient admission.
In this book Carmen Martinez-Vargas explores how academic participatory research and the way it is carried out can contribute to more, or less, social justice. Adopting theoretical and empirical ...approaches, and addressing multiple complex, intersectional issues, this book offers inspiration for scholars and practitioners to open up alternative pathways to social justice, viewed through a Global South lens. Martinez-Vargas examines the colonial roots of research and emphasises the importance of problematising current practices and limitations in order to establish more just and democratic participatory research practices. Although practitioners have been challenging the Western roots of research and participatory research for decades, their goals can be compromised by pluralities and contradictions in the field. This book aims not to replicate past participatory research approaches, but to offer an innovative theoretical foundation—the Capabilities Approach—and an innovative participatory practice called ‘Democratic Capabilities Research’. Democratising Participatory Research is not only timely and relevant in South Africa, but also in the Global North owing to the current crisis of values jeopardising the peaceful existence of diverse societies. The book gives essential recommendations for capabilities and human development scholars to reframe their perspectives and uses of the Capabilities Approach, as well as for participatory practitioners to critically reflect on their practices and their often limited conceptualisation of participation.
In the biosphere, many species live in close proximity and can thus interact in many different ways. Such interactions are dynamic and fall along a continuum between antagonism and cooperation. ...Because interspecies interactions are the key to understanding biological communities, it is important to know how species interactions arise and evolve. Here, we show that the feedback between ecological and evolutionary processes has a fundamental role in the emergence and dynamics of species interaction. Using a two-species artificial community, we demonstrate that ecological processes and rapid evolution interact to influence the dynamics of the symbiosis between a eukaryote (Saccharomyces cerevisiae) and a bacterium (Rhizobium etli). The simplicity of our experimental design enables an explicit statement of causality. The niche-constructing activities of the fungus were the key ecological process: it allowed the establishment of a commensal relationship that switched to ammensalism and provided the selective conditions necessary for the adaptive evolution of the bacteria. In this latter state, the bacterial population radiates into more than five genotypes that vary with respect to nutrient transport, metabolic strategies and global regulation. Evolutionary diversification of the bacterial populations has strong effects on the community; the nature of interaction subsequently switches from ammensalism to antagonism where bacteria promote yeast extinction. Our results demonstrate the importance of the evolution-to-ecology pathway in the persistence of interactions and the stability of communities. Thus, eco-evolutionary dynamics have the potential to transform the structure and functioning of ecosystems. Our results suggest that these dynamics should be considered to improve our understanding of beneficial and detrimental host-microbe interactions.
Objectives
Transitional care nurse (TCN) care has been associated with decreased hospitalizations for older adults in the emergency department (ED). The objective of this study was to evaluate the ...association between TCN care and readmission for geriatric patients who visit the ED within 30 days of a prior hospital discharge.
Methods
We studied a prospective cohort of ED patients aged 65 and older with an ED visit within 30 days of inpatient discharge. Patients with an Emergency Severity Index of 1 or prior TCN contact were excluded. Entropy balancing and logistic regression were used to estimate the average incremental effect of the TCN intervention on risk of admission during the index ED visit and within 30 days of prior discharge.
Results
Of 6,838 visits, 608 included TCN care. TCN patients had lower risk of readmission during the index ED visit at Mount Sinai Medical Center (MSMC), −10.1 percentage points (95% confidence interval CI = −18.5 to −2.7), and Northwestern Memorial Hospital (NMH), −17.3 percentage points (95% CI = −23.1 to −11.5), but not St. Joseph’s Regional Medical Center (SJRMC), −2.5 percentage points (95% CI = −10.5 to 5.5). TCN patients had fewer readmissions within 30 days of prior hospital discharge at NMH, −16.2 percentage points (95% CI = −22.0 to −10.3), but not at MSMC, −5.6 percentage points (95% CI = −13.1 to 1.8), or at SJRMC, 0.5 percentage points (95% CI = −7.2 to 8.2).
Conclusions
Transitional care nurse care in the ED after a prior hospitalization was associated with decreased readmission of older adults during the index ED visit at two of three hospitals, with sustained reduction for the entire 30‐day readmission window at one hospital. TCN interventions in the ED may decrease readmissions for geriatric patients in the ED; however, these results may be dependent on implementation of the program and availability of ED, hospital, and local resources for older adults.
Display omitted
•A strategy for converting biowaste into sugars and biopesticides is evaluated at a prototype scale.•Bacillus thuringiensis biopesticide is produced from the solid residue after ...enzymatic hydrolysis of biowaste.•1 kg of dry biowaste is converted into 338 g of sugars and 2.35 × 1011Bacillus thuringiensis spores.•Effective pH control during SSF was achieved using high-buffering cosubstrates.•Microbial community analysis showed a selective effect during the fermentation process.
Alternative production processes using waste are necessary to preserve non-renewable resources and prevent scarcity of materials for future generations. Biowaste, the organic fraction of municipal solid waste, is abundant and easily available. It can be fractionated into building blocks for which fermentative processes can be designed. By using solid-state fermentation, this paper proposes a method of valorizing biowaste’s residual solid fraction after enzymatic hydrolysis. In a 22 L bioreactor, two digestates from anaerobic digestion processes were evaluated as cosubstrates to modify the acidic pH of the solid residue after enzymatic hydrolysis and promote the growth of the bacterial biopesticide producer Bacillus thuringiensis. Regardless of the cosubstrate used, the final microbial populations were similar indicating microbial specialization. The final product contained 4 × 108 spores per gram of dry matter and also crystal proteins of Bacillus thuringiensis var israelensis, which have insecticidal activity against pests. This method allows for the sustainable use of all materials liberated during the enzymatic hydrolysis of biowaste, including residual solids.
Heavy metal pollution has become a major environmental concern nowadays and the bioremediation of polluted habitats is an increasingly popular strategy due to both its efficiency and safety. A ...screening and selection protocol based on different composting processes was designed in order to isolate heavy metal-resistant microorganisms. A collection of 51 microorganisms was obtained and most of them showed the capability to tolerate heavy metals in multi-polluted aqueous systems (Cd(II), Cr(VI), Ni, Pb, Zn(II)), as well as to remove them. The highest detoxification ratios were observed for Pb. Some of the isolates detoxifying more than a 90% of this metal, while the other metals were removed in a range between 20% and 60%. The best isolates (Graphium putredinis, Fusarium solani, Fusarium sp. and Penicillium chrysogenum) were further assayed in order to determine the predominant removal mechanism and the potential use of their dead biomass as a biosorbent. Intracellular accumulation was the prevalent mechanism for most isolates and metals, with the exception of Ni. In this case, the proportion removed by extracellular adsorption was similar or even higher than that removed by intracellular accumulation. Thus, the efficiency of living cells was higher than that of dead biomass except in the case of Ni.
► Composting is a good reservoir for the isolation of HM-resistant microorganisms. ► Pb was the most removed heavy metal in multi-polluted aqueous systems. ► Intracellular accumulation was the predominant mechanism for heavy metal removal. ► Graphium putredinis, which detoxifies organic pollutants, was the most efficient isolate.
Seawater intrusion in coastal aquifers produces strong physico-chemical gradients. The bacterial community can play a significant role in the biogeochemical reactions in these specific environments. ...The objective of this study was to analyze the prokaryotic community and determine its influence along a vertical saline gradient (from freshwater to saltwater) and pH (from 9 to 5) in 16 m of groundwater column in a carbonate coastal aquifer. Representative samples taken from the freshwater, interface and saltwater were amplified using primers of the hypervariable V3–V4 region of the 16S rRNA gene and sequenced using NGS technology (Next Generation Sequencing) in order to reveal the prokaryotic microbiome, both Bacteria and Archaea. There were clear differences in the prokaryotic community along this profile, in both qualitative and relative quantitative terms. The freshwater layer, in the upper part of the aquifer, was richer in the number of species and was dominated by Proteobacteria which were replaced by Firmicutes and Euryarchaeota as depth and salinity increased. All groundwater levels had, in general, a relatively high diversity of OTUs, most of them showing low relative abundances (< 0.1%). There was a clear interdependence between physicochemical and microbial parameters; firstly, the marine intrusion created a vertical salinity gradient where only the species adapted to these environments could develop. Secondly, the microbial action modified the environment, generating in the upper part an anomalous alkaline pH where specialist species live, such as
Desulfonatronum cooperativum
. As for the interface and saltwater layers, they were clearly acid due to the activity of several sulfates reducing bacteria species, such as
Sulfuriflexus mobilis
or
Desulfomicrobium baculatum
. The latter species is able to oxidize several metals, resulting in a pH decrease in the groundwater and an increase in the concentration of these metals. The acidification mediated by bacteria plays a significant role since it can dissolve the carbonate rock, favoring the landward advance of marine intrusion.
PDF
