This overview was directed towards understanding the relationship of brain functions with dietary choices mainly by older humans. This included food color, flavor, and aroma, as they relate to ...dietary sufficiency or the association of antioxidants with neurodegenerative diseases such as dementia and Alzheimer's disease. Impairment of olfactory and gustatory function in relation to these diseases was also explored. The role of functional foods was considered as a potential treatment of dementia and Alzheimer's disease through inhibition of acetylcholinesterase as well as similar treatments based on herbs, spices and antioxidants therein. The importance of antioxidants for maintaining the physiological functions of liver, kidney, digestive system, and prevention of cardiovascular diseases and cancer has also been highlighted. Detailed discussion was focused on health promotion of the older person through the frequency and patterns of dietary intake, and a human ecology framework to estimate adverse risk factors for health. Finally, the role of the food industry, mass media, and apps were explored for today's new older person generation.
We present a tool to measure gene and protein expression levels in single cells with DNA-labeled antibodies and droplet microfluidics. Using the RNA expression and protein sequencing assay ...(REAP-seq), we quantified proteins with 82 barcoded antibodies and >20,000 genes in a single workflow. We used REAP-seq to assess the costimulatory effects of a CD27 agonist on human CD8
lymphocytes and to identify and characterize an unknown cell type.
Transrenal urine cell-free DNA (cfDNA) is a promising tuberculosis (TB) biomarker, but is challenging to detect because of the short length (<100 bp) and low concentration of TB-specific fragments. ...We aimed to improve the diagnostic sensitivity of TB urine cfDNA by increasing recovery of short fragments during sample preparation. We developed a highly sensitive sequence-specific purification method that uses hybridization probes immobilized on magnetic beads to capture short TB cfDNA (50 bp) with 91.8% average efficiency. Combined with short-target PCR, the assay limit of detection was ≤5 copies of cfDNA in 10 ml urine. In a clinical cohort study in South Africa, our urine cfDNA assay had 83.7% sensitivity (95% CI: 71.0 to 91.5%) and 100% specificity (95% CI: 86.2 to 100%) for diagnosis of active pulmonary TB when using sputum Xpert MTB/RIF as the reference standard. The detected cfDNA concentration was 0.14 to 2,804 copies/ml (median 14.6 copies/ml) and was inversely correlated with CD4 count and days to culture positivity. Sensitivity was nonsignificantly higher in HIV-positive (88.2%) compared to HIV-negative patients (73.3%), and was not dependent on CD4 count. Sensitivity remained high in sputum smear-negative (76.0%) and urine lipoarabinomannan (LAM)-negative (76.5%) patients. With improved sample preparation, urine cfDNA is a viable biomarker for TB diagnosis. Our assay has the highest reported accuracy of any TB urine cfDNA test to date and has the potential to enable rapid non-sputum-based TB diagnosis across key underserved patient populations.
Although inherited bleeding disorders (IBDs) affect both females and males, this review of the preoperative diagnosis and management of IBDs focuses on genetic and gynecologic screening, diagnosis ...and management of affected and carrier females. A PubMed literature search was conducted, and the peer-reviewed literature on IBDs was evaluated and summarized. Best-practice considerations for screening, diagnosis and management of IBDs in female adolescents and adults, with GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) evidence level and ranking of recommendation strength, are presented. Health care providers need to increase their recognition of and support for female adolescents and adults with IBDs. Improved access to counselling, screening, testing and hemostatic management is also required. Patients should be educated and encouraged to report abnormal bleeding symptoms to their health care provider when they have a concern. It is hoped that this review of preoperative IBD diagnosis and management will enhance access to women-centred care to increase patients' understanding of IBDs and decrease their risk of IBD-related morbidity and mortality.
Summary The aim of diagnostic point-of-care testing is to minimise the time to obtain a test result, thereby allowing clinicians and patients to make a quick clinical decision. Because point-of-care ...tests are used in resource-limited settings, the benefits need to outweigh the costs. To optimise point-of-care testing in resource-limited settings, diagnostic tests need rigorous assessments focused on relevant clinical outcomes and operational costs, which differ from assessments of conventional diagnostic tests. We reviewed published studies on point-of-care testing in resource-limited settings, and found no clearly defined metric for the clinical usefulness of point-of-care testing. Therefore, we propose a framework for the assessment of point-of-care tests, and suggest and define the term test efficacy to describe the ability of a diagnostic test to support a clinical decision within its operational context. We also propose revised criteria for an ideal diagnostic point-of-care test in resource-limited settings. Through systematic assessments, comparisons between centralised testing and novel point-of-care technologies can be more formalised, and health officials can better establish which point-of-care technologies represent valuable additions to their clinical programmes.
Widely accepted tectonic reconstructions indicate at least 100 km of coast‐parallel northwestward translation of the Sierra Nevada block of California and 15–20° clockwise rotation of most of Oregon ...since the current phase of Basin and Range extension began ∼17 Ma. These reconstructions require at least 100 km of convergence between the central Coast Range of Oregon and rigid North America in mainland British Columbia, yet there is little discussion of how such convergence might be distributed. This study offers a kinematic model of the distribution of such deformation, constrained by geodesy, paleomagnetism, and fault offsets in Nevada, California and Oregon. The model includes differential rotation across the thrust faults of the Yakima fold and thrust belt (YFTB), compressive right‐lateral faulting in the Washington Cascade Range, substantial thrust faulting within the Puget Lowland, and oroclinal bending and doming in the Olympic Mountains. Shortening across YTFB along 120°W longitude is modeled as 47 km, across Puget Lowland at 123°W (Olympia‐Bellingham) is 94 km, and total shortening between the central Oregon Coast Range and northern Washington (Corvallis‐Bellingham) is 125 km. Current motion of the coastal regions above the Cascadia subduction zone results from both permanent deformation of the continent and elastic coupling to the subducting plate. Permanent deformation in the model is based on extrapolating geodesy from east of 120°W or south of 40°N, indicating a very uniform convergence velocity with the Juan de Fuca plate for northernmost California and Oregon near 31 mm/yr at N61°E.
Plain Language Summary
Widely accepted reconstructions of large scale motion in California, Nevada, and Oregon indicate that over the last 17 million years, Oregon has rotated nearly rigidly by 15–20° relative to interior North America about a pivot point near the northeastern corner of the state. With mainland British Columbia widely regarded as part of rigid North America, this rotation implies western Washington has shortened by at least 100 km as northwestern Oregon approaches Canada. Lack of understanding of which faults have accumulated the most motion limits our understanding of earthquake risk. This study offers a reconstruction model as a first effort to propose a regionally complete summary of how this deformation could be distributed across individual faults. In the densely populated Puget Lowland region of northwestern Washington, the model includes 94 km of shortening between Olympia and Bellingham, including 40 km of shortening across the Seattle fault.
Key Points
Deformation of Washington resulting from a 15° clockwise rotation of Oregon can be accommodated in a geologically reasonable model
Modeled shortening includes 94 km across urban Puget Lowland and 47 km across Yakima fold and thrust belt
Accounting for deformation of North America, the Cascadia subduction zone has fairly uniform convergence rate of ∼31 mm/yr for 42–46°N
Abstract Objective To provide updated information on the pre- and post-conception use of oral folic acid with or without a multivitamin/micronutrient supplement for the prevention of neural tube ...defects and other congenital anomalies This will help physicians, midwives, nurses, and other health care workers to assist in the education of women about the proper use and dosage of folic acid/multivitamin supplementation before and during pregnancy. Evidence Published literature was retrieved through searches of PubMed, Medline, CINAHL, and the Cochrane Library in January 2011 using appropriate controlled vocabulary and key words (e.g., folic acid, prenatal multivitamins, folate sensitive birth defects, congenital anomaly risk reduction, pre-conception counselling). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies published in English from 1985 and June 2014. Searches were updated on a regular basis and incorporated in the guideline to June 2014 Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies Costs, risks, and benefits The financial costs are those of daily vitamin supplementation and eating a healthy folate-enriched diet. The risks are of a reported association of dietary folic acid supplementation with fetal epigenetic modifications and with an increased likelihood of a twin pregnancy These associations may require consideration before initiating folic acid supplementation The benefit of folic acid oral supplementation or dietary folate intake combined with a multivitamin/micronutrient supplement is an associated decrease in neural tube defects and perhaps in other specific birth defects and obstetrical complications. Values The quality of evidence in the document was rated using the criteria described in the Report of the Canadian Task Force on Preventative Health Care ( Table 1 ).
Aims
Fatal adverse drug reactions (ADRs) are important causes of death, but data from resource‐limited settings are scarce. We determined the proportion of deaths in South African medical inpatients ...attributable to ADRs, and their preventability, stratified by human immunodeficiency virus (HIV) status.
Methods
We reviewed the folders of all patients who died over a 30 day period in the medical wards of four hospitals. We identified ADR‐related deaths (deaths where an ADR was ‘possible’, ‘probable’ or ‘certain’ using WHO‐UMC criteria and where the ADR contributed to death). We determined preventability according to previously published criteria.
Results
ADRs contributed to the death of 2.9% of medical admissions and 56 of 357 deaths (16%) were ADR‐related. Tenofovir, rifampicin and co‐trimoxazole were the most commonly implicated drugs. 43% of ADRs were considered preventable. The following factors were independently associated with ADR‐related death: HIV‐infected patients on antiretroviral therapy (adjusted odds ratio (aOR) 4.4, 95% confidence interval (CI) 1.6, 12), exposure to more than seven drugs (aOR 2.5, 95% CI 1.3, 4.8) and increasing comorbidity score (aOR 1.3, 95% CI 1.1, 1.7).
Conclusions
In our setting, where HIV and tuberculosis are highly prevalent, fatal in‐hospital ADRs were more common than reported in high income settings. Most deaths were attributed to drugs used in managing HIV and tuberculosis. A large proportion of the ADRs were preventable, highlighting the need to strengthen systems for health care worker training and support.
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