Abstract Methods The American Society of Anesthesiologists Physical Status classification system (ASA PS) is a method of characterizing patient operative risk on a scale of 1–5, where 1 is normal ...health and 5 is moribund. Every anesthesiologist is trained in this measure, and it is performed before every procedure in which a patient undergoes anesthesia. We measured the independent predictive value of ASA-PS for complications and mortality in the ACS-NSQIP database by multivariate regression. We conducted analogous regressions after standardizing ASA-PS to control for interprocedural variations in risk in the overall model and sub-analyses by surgical specialty and the most common procedures. Results For 2,297,629 cases (2005–2012; median age 55, min = 16, max>90 90 and above are coded as 90+), at increasing levels of ASA-PS (2–5), odds ratios (OR's) from 2.05 to 63.25 (complications, p < 0.001) and 5.77–2011.92 (mortality, p < 0.001) were observed, with non-overlapping 95% confidence intervals. Standardization of ASA-PS (OR = 1.426 per standard deviation above the mean ASA-PS per procedure, p < .001) and subgroup analyses yielded similar results. Discussion ASA PS was not only found to be associated with increased morbidity and mortality, but independently predictive when controlling for other comorbidities. Even after standardization based on procedure type, increases in ASA predicted significant increases in complication rates for morbidity and mortality post-operatively. Conclusions ASA PS has strong, independent associations with post-operative medical complications and mortality across procedures. This capability, along with its simplicity, makes it a valuable prognostic metric.
Non-alcoholic fatty liver disease encompasses a spectrum of liver diseases, including simple steatosis, steatohepatitis, liver fibrosis and cirrhosis and hepatocellular carcinoma. Non-alcoholic fatty ...liver disease is currently the most dominant chronic liver disease in Western countries due to the fact that hepatic steatosis is associated with insulin resistance, type 2 diabetes mellitus, obesity, metabolic syndrome and drug-induced injury. A variety of chemicals, mainly drugs, and diets is known to cause hepatic steatosis in humans and rodents. Experimental non-alcoholic fatty liver disease models rely on the application of a diet or the administration of drugs to laboratory animals or the exposure of hepatic cell lines to these drugs. More recently, genetically modified rodents or zebrafish have been introduced as non-alcoholic fatty liver disease models. Considerable interest now lies in the discovery and development of novel non-invasive biomarkers of non-alcoholic fatty liver disease, with specific focus on hepatic steatosis. Experimental diagnostic biomarkers of non-alcoholic fatty liver disease, such as (epi)genetic parameters and ‘-omics’-based read-outs are still in their infancy, but show great promise. In this paper, the array of tools and models for the study of liver steatosis is discussed. Furthermore, the current state-of-art regarding experimental biomarkers such as epigenetic, genetic, transcriptomic, proteomic and metabonomic biomarkers will be reviewed.
The metabolic effects of omega-6 polyunsaturated fatty acids (PUFAs) remain contentious, and little evidence is available regarding their potential role in primary prevention of type 2 diabetes. We ...aimed to assess the associations of linoleic acid and arachidonic acid biomarkers with incident type 2 diabetes.
We did a pooled analysis of new, harmonised, individual-level analyses for the biomarkers linoleic acid and its metabolite arachidonic acid and incident type 2 diabetes. We analysed data from 20 prospective cohort studies from ten countries (Iceland, the Netherlands, the USA, Taiwan, the UK, Germany, Finland, Australia, Sweden, and France), with biomarkers sampled between 1970 and 2010. Participants included in the analyses were aged 18 years or older and had data available for linoleic acid and arachidonic acid biomarkers at baseline. We excluded participants with type 2 diabetes at baseline. The main outcome was the association between omega-6 PUFA biomarkers and incident type 2 diabetes. We assessed the relative risk of type 2 diabetes prospectively for each cohort and lipid compartment separately using a prespecified analytic plan for exposures, covariates, effect modifiers, and analysis, and the findings were then pooled using inverse-variance weighted meta-analysis.
Participants were 39 740 adults, aged (range of cohort means) 49-76 years with a BMI (range of cohort means) of 23·3-28·4 kg/m
, who did not have type 2 diabetes at baseline. During a follow-up of 366 073 person-years, we identified 4347 cases of incident type 2 diabetes. In multivariable-adjusted pooled analyses, higher proportions of linoleic acid biomarkers as percentages of total fatty acid were associated with a lower risk of type 2 diabetes overall (risk ratio RR per interquintile range 0·65, 95% CI 0·60-0·72, p<0·0001; I
=53·9%, p
=0·002). The associations between linoleic acid biomarkers and type 2 diabetes were generally similar in different lipid compartments, including phospholipids, plasma, cholesterol esters, and adipose tissue. Levels of arachidonic acid biomarker were not significantly associated with type 2 diabetes risk overall (RR per interquintile range 0·96, 95% CI 0·88-1·05; p=0·38; I
=63·0%, p
<0·0001). The associations between linoleic acid and arachidonic acid biomarkers and the risk of type 2 diabetes were not significantly modified by any prespecified potential sources of heterogeneity (ie, age, BMI, sex, race, aspirin use, omega-3 PUFA levels, or variants of the FADS gene; all p
≥0·13).
Findings suggest that linoleic acid has long-term benefits for the prevention of type 2 diabetes and that arachidonic acid is not harmful.
Funders are shown in the appendix.
Refrigerated raw milk may contain psychrotrophic microorganisms that produce thermoresistant exoproteases and lipases, which may compromise the quality of processed fluid milk and dairy products ...during storage. The aim of this work was to quantify and identify the deteriorating psychrotrophic microbiota in Brazilian refrigerated raw milk using genetic diversity analysis. The mean psychrotrophic count was 1.1 × 104 cfu/mL. Of the total isolates, 47.8 and 29.8% showed deteriorating activity at 35°C within 48 h and 7°C within 10 d, respectively. Among the proteolytic species, more isolated by this study were Lactococcus lactis (27.3%), Enterobacter kobei (14.8%), Serratia ureilytica (8%), Aerococcus urinaeequi (6.8%), and Bacillus licheniformis (6.8%). Observed among lipolytics were E. kobei (17.7%), L. lactis (15.6%), A. urinaeequi (12.5%), and Acinetobacter lwoffii (9.4%). The isolates S. ureilytica, E. kobei, Pseudomonas spp., and Yersinia enterocolitica potentially produced alkaline metalloprotease (aprX). Despite the low counts, a considerable portion of the psychrotrophic microbiota presented spoilage potential, which reaffirms the need for rigor in the control of contamination and the importance of rapid processing as factors that maintain the quality of milk and dairy products.
Vaginal infections are extremely prevalent, particularly among women of reproductive age. Although they do not result in high mortality rates, these infections are associated with high levels of ...anxiety and reduction of quality of life. In most cases, topical treatment of vaginal infections has been shown to be at least as effective as oral treatment, resulting in higher local drug concentrations, with fewer drug interactions and adverse effects. Furthermore, the emergence of microbial resistance to chemotherapeutics and the difficulties in managing infection recurrences sustain the need for more effective local treatments. However, conventional dosage forms have been associated with low retention in the vagina and discomfort.
Formulation strategies such as the development of bioadhesive, thermogelling systems and microtechnological or nanotechnological approaches have been proposed to improve delivery of traditional drugs, and other treatment modalities such as new drugs, plant extracts, and probiotics are being studied.
This article reviews the recent strategies studied to improve the treatment and prevention of the commonest vaginal infections—namely, vaginal bacteriosis, aerobic vaginitis, vulvovaginal candidosis, and trichomoniasis—through the intravaginal route.
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Lors de la parution en 2020 de la retraduction française du roman Dix petits nègres d’Agatha Christie, rebaptisé Ils étaient dix, la Christie Corporation a déclaré que cette nouvelle version de ...l’œuvre avait du sens. Selon le communiqué, au siècle de l’auteure le langage était différent. Afin d’interroger le bienfondé de cet argument, notre étude porte sur la traduction et usage du terme Nigger/Nègre (nom/adjectif) en français métropolitain. Le corpus est composé de l’œuvre originale Ten Little Niggers (1939), sa traduction interlinguale (1940) et retraduction (2020). Ces concepts-ci sont examinés dans la première partie de l’étude à l’appui des bases théoriques de l’intertextualité. La deuxième partie suit le parcours de la lexie aux États-Unis à travers notamment la popularisation de la comptine éponyme originale. La troisième partie vise à démontrer qu’à l’instar du statut sociolinguistique du N… word aux États-Unis, Nègre/nègre n’a jamais intégré le vocabulaire usuel du français. Ce sont-là autant d’éléments qui permettent de contester voire invalider l’argument présenté par les ayants-droits de l’auteure. La conclusion expose les résultats du baromètre des discriminations en France CRAN/IPSOS (2023) et souligne la nécessité de déconstruction de l’imaginaire colonial institutionalisé.
When the French retranslation of the novel Ten Little Niggers, by Agatha Christie, renamed They were ten, was published in 2020, the Christie Corporation declared that this new version of the work makes sense. According to the press release, in the century of the author the language was different. To question the validity of this argument, our study focuses on the translation and use of the term Nigger/Nègre (noun/adjective) in metropolitan French. The corpus is composed of the original work Ten Little Niggers (1939), its interlingual translation (1940) and retranslation (2020). These concepts are examined in the first part of the study in support of the theoretical bases of intertextuality. The second part follows the journey of the lexie in the United States, notably through the popularization of the original eponymous nursery rhyme. The third part aims to demonstrate that, like the sociolinguistic status of the N… word in the United States, the lexie Nègre/nègre has never integrated the usual vocabulary of French. These are all elements that make it possible to contest or even invalidate the argument presented by the author's heirs. The conclusion exposes the results of the CRAN/IPSOS discrimination barometer in France (2023) and underlines the need to deconstruct the institutionalized colonial imaginary.
Dengue virus (DENV) and chikungunya virus (CHIKV) are reemergent arboviruses that are transmitted by mosquitoes of the Aedes genus. During the last several decades, these viruses have been ...responsible for millions of cases of infection and thousands of deaths worldwide. Therefore, several investigations were conducted over the past few years to find antiviral compounds for the treatment of DENV and CHIKV infections. One attractive strategy is the screening of compounds that target enzymes involved in the replication of both DENV and CHIKV. In this review, we describe advances in the evaluation of natural products targeting the enzymes involved in the replication of these viruses.
O objetivo deste trabalho foi avaliar o efeito do biochar de torta de filtro como condicionador de solo e sua influência no crescimento e na fisiologia de macaúba, araçá e cajuzinho do cerrado. Os ...experimentos foram montados na Fazenda Hamilton de Abreu Navarro da UFMG, onde foram avaliados o efeito de quatro doses de biochar de torta de filtro (1%, 2%, 4% e 8% v/v) e dois tratamentos controle: um com correção do solo e adubação mineral, e o outro sem adubação. Para acompanhar o desempenho das mudas, foram realizadas avaliações aos 30, 60 e 120 dias após o transplantio, dos parâmetros fisiológicos (fotossíntese, transpiração, condutância estomática, CO2 consumido, carbono interno e taxa de transporte de elétrons), e morfológicos (altura e diâmetro), aos 30, 60, 90 e 120 dias após o transplantio. Aos 120 dias, avaliou-se a produção de biomassa seca da parte aérea, de raízes e total. Para a macaúba, a aplicação de biochar, na dose de 2%, favoreceu a sua fotossíntese. Já para o araçá, aos 30 dias após o transplantio, o tratamento sem adubação foi melhor para a maioria das variáveis, entretanto os tratamentos com biochar também tiveram resultados satisfatórios. O cajuzinho do cerrado também respondeu positivamente à aplicação de biochar em todas as doses. As variáveis fisiológicas e morfológicas responderam bem aos tratamentos sem adubação e com aplicação de biochar ao solo. Portanto, o biochar de torta de filtro pode ser indicado no plantio das espécies estudadas, assim como a não aplicação de corretivo e fertilizante mineral.