Background
Up to 40 per cent of patients undergoing oesophagectomy develop pneumonia. The aim of this study was to assess whether preoperative inspiratory muscle training (IMT) reduces the rate of ...pneumonia after oesophagectomy.
Methods
Patients with oesophageal cancer were randomized to a home‐based IMT programme before surgery or usual care. IMT included the use of a flow‐resistive inspiratory loading device, and patients were instructed to train twice a day at high intensity (more than 60 per cent of maximum inspiratory muscle strength) for 2 weeks or longer until surgery. The primary outcome was postoperative pneumonia; secondary outcomes were inspiratory muscle function, lung function, postoperative complications, duration of mechanical ventilation, length of hospital stay and physical functioning.
Results
Postoperative pneumonia was diagnosed in 47 (39·2 per cent) of 120 patients in the IMT group and in 43 (35·5 per cent) of 121 patients in the control group (relative risk 1·10, 95 per cent c.i. 0·79 to 1·53; P = 0·561). There was no statistically significant difference in postoperative outcomes between the groups. Mean(s.d.) maximal inspiratory muscle strength increased from 76·2(26·4) to 89·0(29·4) cmH2O (P < 0·001) in the intervention group and from 74·0(30·2) to 80·0(30·1) cmH2O in the control group (P < 0·001). Preoperative inspiratory muscle endurance increased from 4 min 14 s to 7 min 17 s in the intervention group (P < 0·001) and from 4 min 20 s to 5 min 5 s in the control group (P = 0·007). The increases were highest in the intervention group (P < 0·050).
Conclusion
Despite an increase in preoperative inspiratory muscle function, home‐based preoperative IMT did not lead to a decreased rate of pneumonia after oesophagectomy. Registration number: NCT01893008 (https://www.clinicaltrials.gov).
Increased muscle function, no better outcome
Using strontium (Sr) and barium (Ba) in otoliths to determine natal origins and understand patterns of fish movements is based on the fundamental assumption that otoliths record water chemistry ...signals without any major alterations. Although prior studies highlighted that fish physiology can modify the water signal in otoliths, studies for freshwater fish are scarce. We exposed different groups of Atlantic salmon parr Salmo salar to different scenarios of ambient-level variations in Sr/Ca and Ba/Ca ratios and then combined otolith chemical profiles with environmental data (water chemistry and temperature), Fulton's index, and otolith growth rates to assess what factors explain/influence the elemental ratios of Sr and Ba in otoliths. Generalized additive mixed models (GAMMs) using water-based otolith composition, temperature, Fulton's index, and “individual” as explanatory variables allow to demonstrate that water chemistry alone cannot fully explain measured ratios in otoliths, except in scenarios involving significant changes in water chemistry. Other factors (physiological effects) should be accounted for reproducing short and minimal seasonal variations in water composition, considering that inter-individual variability contributes quite significantly in most scenarios.
Introduction
Cancer survivors frequently report suffering from neurocognitive impairment, that persists after physical recovery from their disease. Cognitive impairment is associated with important ...emotional disturbances, socio-professional consequences and diminished quality of life.
Objectives
This observational study aims to assess the effectives of an integrative neurocognitive remediation therapy (iNRCT), offered as a 12-week program (1day/week), organized within our Cognitive Remediation Clinic. The iNCRT combines personalized computerized cognitive training and neurocognitive strategy training, with group sessions of physical exercise, mindfulness, and cognitive behavior therapy (CBT).
Methods
The assessment before and after NCRT includes neuropsychological testing (10 subtests), assessment of daily functioning and subjective neurocognitive function (NCF).
Results
Out of 16 eligible cancer survivors, 12 patients were recruited and 11 completed the iNCRT; median age 53 years range, 41-71; 3 patients had a prior history of a central nervous system tumor, 5 patients of breast cancer, 2 patients of stage-IV melanoma, and 1 patient of gastric cancer. After iNCRT subjective NCF did not improve significantly (p=0.13) according to the Cognitive Failure Questionnaire. However neuropsychological assessment revealed an improvement on ≥ 1 impaired subtest in all patients; 6 patients improved on ≥ 4 impaired subtests. Improvement was most prominent in long-term verbal and visual memory, working memory and executive function. All patients reported a clinical benefit in their daily function after completion of iNCRT.
Conclusions
Our iNRCT, which combines personalized neurocognitive training with physical exercise, mindfulness and CBT can be an effective therapeutic model for treating neurocognitive impairment in cancer survivors, with a clinically relevant impact on their daily function.
Disclosure
No significant relationships.
To evaluate the association between body mass index (BMI, kg m⁻²) and mortality rate among Hispanic adults.
Analysis of five data sets (total N=16,798) identified after searching for publicly ...available, prospective cohort data sets containing relevant information for at least 500 Hispanic respondents (≥18 years at baseline), at least 5 years of mortality follow-up, and measured height and weight. Data sets included the third National Health and Nutrition Examination Survey, the Puerto Rico Heart Health Program (PRHHP), the Hispanic Established Population for Epidemiologic Studies of the Elderly (HEPESE), the San Antonio Heart Study (SAHS) and the Sacramento Area Latino Study on Aging.
Cox proportional hazards regression models, adjusting for sex and smoking, were fit within three attained-age strata (18 to younger than 60 years, 60 to younger than 70 years, and 70 years and older). We found that underweight was associated with elevated mortality rate for all age groups in the PRHHP (hazard ratios HRs=1.38-1.60) and the SAHS (HRs=1.88-2.51). Overweight (HRs=0.38 and 0.84) and obesity grade 2-3 (HRs=0.75 and 0.60) associated with reduced mortality rate in the HEPESE dataset for those in the 60 to younger than 70 years, and 70 years and older attained-age strata. Weighted estimates combining the HRs across the data sets revealed a similar pattern.
Among Hispanic adults, there was no clear evidence that overweight and obesity associate with elevated mortality rate.
Aims: The influence of biosurfactant compounds produced by a strain of Pseudomonas fluorescens on the adhesion of Listeria monocytogenes LO28 to polytetrafluoroethylene (PTFE) and AISI 304 stainless ...steel surfaces was investigated. Methods and Results: The biosurfactant was produced according to a simple, novel technique based on cultivation on nutrient agar. Adhesion studies were performed using L. monocytogenes cells cultured at 20 or 37 degrees C. Conclusions: A substrate-dependent behaviour of the LO28 strain (larger number of cells adhering to stainless steel than to PTFE), and a significant reduction (< 90%) in microbial adhesion levels through the prior adsorption of biosurfactants on stainless steel surfaces, which can be related to a change in the electron-donor characteristics of this substratum, was demonstrated. Significance and Impact of the Study: The prior adsorption of biosurfactants on solid surfaces may constitute a new and effective means of combating the implantation of pathogenic micro-organisms in food processing plants.
The anti-apoptotic protein myeloid cell leukemia 1 (Mcl-1) plays an important role in survival and differentiation of leukocytes, more specifically of neutrophils. Here, we investigated the impact of ...myeloid Mcl-1 deletion in atherosclerosis. Western type diet fed LDL receptor-deficient mice were transplanted with either wild-type (WT) or LysMCre Mcl-1
(Mcl-1
) bone marrow. Mcl-1 myeloid deletion resulted in enhanced apoptosis and lipid accumulation in atherosclerotic plaques. In vitro, Mcl-1 deficient macrophages also showed increased lipid accumulation, resulting in increased sensitivity to lipid-induced cell death. However, plaque size, necrotic core and macrophage content were similar in Mcl-1
compared to WT mice, most likely due to decreased circulating and plaque-residing neutrophils. Interestingly, Mcl-1
peritoneal foam cells formed up to 45% more multinucleated giant cells (MGCs) in vitro compared to WT, which concurred with an increased MGC presence in atherosclerotic lesions of Mcl-1
mice. Moreover, analysis of human unstable atherosclerotic lesions also revealed a significant inverse correlation between MGC lesion content and Mcl-1 gene expression, coinciding with the mouse data. Taken together, these findings suggest that myeloid Mcl-1 deletion leads to a more apoptotic, lipid and MGC-enriched phenotype. These potentially pro-atherogenic effects are however counteracted by neutropenia in circulation and plaque.
Abstract Fragile-X syndrome (FXS) is caused by the transcriptional repression of the Fmr1 gene resulting in loss of the Fragile-X mental retardation protein (FMRP). This leads to cognitive impairment ...in both male and female patients, however few studies have focused on the impact of FXS in females. Significant cognitive impairment has been reported in approximately 35% of women who exhibit a heterozygous Fmr1 gene mutation, however to date there is a paucity of information regarding the mechanistic underpinnings of these deficits. We, and others, have recently reported that there is significant impairment in N-methyl- d -aspartate receptor (NMDAR)-dependent long-term potentiation (LTP) and long-term depression (LTD) in the hippocampal dentate gyrus (DG) of male Fmr1 knock out mice. Here we examined if female mice displaying a heterozygous loss of the Fmr1 gene ( Fmr1 ± ) would exhibit similar impairments in DG-dependent spatial memory processing and NMDAR hypofunction. We found that Female Fmr1 ± mice did not show impaired metabotropic glutamate receptor (mGluR)-LTD in the CA1 region, and could perform well on a temporal ordering task that is thought to involve this brain region. In contrast, female Fmr1 ± mice showed impairments in a pattern separation task thought to involve the DG, and also displayed a significant impairment in both NMDAR-dependent LTD and LTP in this region. The LTP impairment could be rescued by administering the NMDAR co-agonist, glycine. Our data suggests that NMDAR hypofunction in the DG may partly contribute to learning and memory impairment in female Fmr1 ± mice. Targeting NMDAR-dependent mechanisms may offer hope as a new therapeutic approach for treating female FXS patients with learning and memory impairments.
The capacity of many plant species to resprout in fire-prone shrublands is thought to engender persistence, yet management concerns exist for the long-term persistence of some resprouting species ...given anthropogenic impacts including shortened fire intervals, long periods of fire exclusion, and/or fires of increasingly high severity. We explored the potential demographic effects of different fire interval regimes on lignotuberous resprouter species using the last fire interval for 36 sites (33 experimental fires, 3 wildfires) in biodiverse SW Australian shrublands, spanning an interval range of 3-42 years. Mortality and regrowth 1 year following the last fire was assessed for >7,000 tagged individuals from 20 shrub and sub-shrub species. Using generalized linear mixed effect models, we estimated the influence of fire interval (and selected fire and environmental covariates) on mortality and regrowth rates across all species, and individually for the four most common species. The overall model, as well as the models for three of the four most common species (Banksia attenuata, Melaleuca leuropoma, and M. systena, but not Hibbertia hypericoides) supported the hypothesis of increased mortality at short and long fire intervals, most likely due to total non-structural carbohydrate (TNC) and bud-bank limitation, respectively. However, no relationship between regrowth rate and fire interval was detected, suggesting that increased mortality at short (3-5 year) fire intervals may not be due solely to resource (TNC) limitation. Results show that lignotuberous resprouters are potentially vulnerable to population decline through attrition of mature plants under both shortened and lengthened fire interval regimes.
Electrochemical and mass-transport properties of a redox-active ionic liquid, 1-(ferrocenylmethyl)-3-methylimidazolium bis(trifluoromethanesulfonyl)amide (FcEmiTFSI), were investigated for the pure ...compound and for solutions in acetonitrile (ACN) and in a room-temperature ionic liquid, 1-ethyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide (EmiTFSI). Cyclic voltammetry data were compared with those obtained for the oxidation of ferrocene (Fc) in EmiTFSI and ACN. The half-potential of FcEmiTFSI/Fc
+EmiTFSI is higher than that of Fc/Fc
+ in both media. The apparent heterogeneous rate constants
k
app
°
of FcEmiTFSI and Fc were determined in both solvents. The values of
k
app
°
for these two redox probes in the same solvent are of the same order of magnitude. However,
k
app
°
is lower in EmiTFSI than in ACN. Comparison of
k
app
°
in these solvents indicates that the decrease in
k
app
°
cannot be explained in terms of Marcus–Hush theory. The electrochemical and mass-transport properties of FcEmiTFSI in EmiTFSI were investigated by means of scanning electrochemical microscopy (SECM). The tip current depends upon the tip velocity. With high tip velocity, one observes that the tip current increases as the distance between the tip and insulating substrate decreases. This behavior is not due to a positive feedback mechanism. It is interpreted in terms of mixed diffusion and convective mass transfer control.
The duration of eXDR carriage depends on several factors that might be difficult to recover. We aim to assess the duration of eXDR carriage by using a simple to recover parameter: the number of ...consecutive negative screening. 131 eXDR carriers (51 VRE and 80 CPE) were included. The number of consecutive negative screenings was strongly associated with eXDR clearance. All patients displaying at least three negative screenings over a seven-month period were never screened positive thereafter. Taking into account the number of negative screenings as a part of a case-by-case risk assessment would be helpful for the decision to maintain or lift eXDR-focused precautions.
PDF
