Novel anesthetic and analgesic agents are currently under development or investigation to improve anesthetic delivery and patient care. The pharmacokinetic and analgesic profiles of these agents are ...especially tailored to meet the challenges of rapid recovery and opioid minimization associated with ambulatory anesthesia practice.
OBJECTIVE: High water consumption has been proposed as an aid to weight control and as a means of reducing the energy density of the diet. This study examines the relationship between water ...consumption and other drinking and eating patterns. RESEARCH METHODS AND PROCEDURES: The National Health and Nutrition Examination Survey 1999 to 2001, with responses from 4755 individuals >/=18 years of age, provides the data for this cross-sectional analysis. A cluster analysis was performed using z-scores of specific food and beverage consumption to examine patterns. A multinomial logit analysis was used to examine sociodemographic characteristics of each dietary pattern and to examine the effects of water consumption on the likelihood of consuming a non-dairy caloric beverage. All results were weighted to be nationally representative and controlled for design effects. RESULTS: Within the sample, 87% consumed water, with an average daily consumption of 51.9 oz (1.53 liters) per consumer. Water consumers drank fewer soft/fruit drinks and consumed 194 fewer calories per day. Water consumers (potentially a self-selected sample) consumed more fruits, vegetables, and low- and medium-fat dairy products. Four distinct unhealthy dietary patterns were found that included little or no water consumption. Older and more educated persons used healthier food patterns. Mexican dietary patterns were much healthier than dietary patterns of blacks. DISCUSSION: Water consumption potentially is a dietary component to be promoted, but much more must be understood about its role in a healthy diet. Because high water consumption is linked with healthier eating patterns--patterns more likely to be followed by higher-educated, older adults--the target of water promotion and healthy diet options should focus on younger and less educated adults.
The FASSET whole farm model was extended with a sub-model for competition between several plant species for light, water and nitrogen. The new model was tested on intercrops of pea (
Pisum sativum ...L.) and spring barley (
Hordeum vulgare L.). A 3-year dataset on pea and barley sole crop growth was used for calibration. Two datasets that included detailed measurements of crop production, nitrogen uptake and leaf area indices from two sites were used for testing. An arable organic experiment from three sites including several treatments over 4 years was also used for testing.
The model predicted the increase in resource utilisation of pea and barley and effects on pea symbiotic nitrogen fixation satisfactorily. The effects of pea interspecific competition on barley production agreed with observations, but the simulated effect of barley interspecific competition on pea was underestimated. Sensitivity analyses showed that the vertical distribution of barley leaf area had a great influence on the outcome of the interspecific competition between the barley and pea crops.
Some developmental dual-acting PPARα/γ agonists, such as ragaglitazar, have shown carcinogenic effects in the rodent urinary bladder urothelium after months-years of dosing. We examined early ...(precancerous) changes in the bladder urothelium of rats orally dosed with ragaglitazar, using a newly developed flow cytometric method. Following 3 weeks of oral ragaglitazar dosing, increases in physical size occurred in a generalized fashion in rat bladder urothelial cells, determined by flow cytometry. Protein/DNA measurements confirmed increased protein content of urothelial cells in the bladder, and hypertrophy was observed in the kidney pelvis urothelium by histopathology. In animals exhibiting urothelial hypertrophy, no cell cycle changes were detected in parallel samples of bladder urothelium. Interestingly, urothelial cells from normal rats were found to constitute a unique type of noncycling population, with high G2/M fractions. In summary, our findings showed that in the urothelium of ragaglitazar-treated animals, hypertrophy (increased size and protein content per cell) was an early change, that affected the whole bladder urothelial cell population. The urothelial hypertrophy was primary, i.e., occurred in the absence of similarly pronounced changes in cell cycle distributions. To our knowledge, this is the first report of a direct hypertrophic effect of a PPAR agonist. Urothelial hypertrophy might be a relevant early biological endpoint in mechanistic studies regarding the bladder-carcinogenic effect of PPAR agonists.
Background Spontaneous abortion is the most commonly observed adverse pregnancy outcome. The angiogenic factors soluble Fms-like kinase 1 and placental growth factor are critical for normal pregnancy ...and may be associated to spontaneous abortion. Objective We investigated the association between maternal serum concentrations of soluble Fms-like kinase 1 and placental growth factor, and subsequent spontaneous abortion. Study Design In the prospective observational Odense Child Cohort, 1676 pregnant women donated serum in early pregnancy, gestational week <22 (median 83 days of gestation, interquartile range 71-103). Concentrations of soluble Fms-like kinase 1 and placental growth factor were determined with novel automated assays. Spontaneous abortion was defined as complete or incomplete spontaneous abortion, missed abortion, or blighted ovum <22+0 gestational weeks, and the prevalence was 3.52% (59 cases). The time-dependent effect of maternal serum concentrations of soluble Fms-like kinase 1 and placental growth factor on subsequent late first-trimester or second-trimester spontaneous abortion (n = 59) was evaluated using a Cox proportional hazards regression model, adjusting for body mass index, parity, season of blood sampling, and age. Furthermore, receiver operating characteristics were employed to identify predictive values and optimal cut-off values. Results In the adjusted Cox regression analysis, increasing continuous concentrations of both soluble Fms-like kinase 1 and placental growth factor were significantly associated with a decreased hazard ratio for spontaneous abortion: soluble Fms-like kinase 1, 0.996 (95% confidence interval, 0.995–0.997), and placental growth factor, 0.89 (95% confidence interval, 0.86–0.93). When analyzed by receiver operating characteristic cut-offs, women with soluble Fms-like kinase 1 <742 pg/mL had an odds ratio for spontaneous abortion of 12.1 (95% confidence interval, 6.64–22.2), positive predictive value of 11.70%, negative predictive value of 98.90%, positive likelihood ratio of 3.64 (3.07-4.32), and negative likelihood ratio of 0.30 (0.19-0.48). For placental growth factor <19.7 pg/mL, odds ratio was 13.2 (7.09-24.4), positive predictive value was 11.80%, negative predictive value was 99.0%, positive likelihood ratio was 3.68 (3.12-4.34), and negative likelihood ratio was 0.28 (0.17-0.45). In the sensitivity analysis of 54 spontaneous abortions matched 1:4 to controls on gestational age at blood sampling, the highest area under the curve was seen for soluble Fms-like kinase 1 in prediction of first-trimester spontaneous abortion, 0.898 (0.834-0.962), and at the optimum cut-off of 725 pg/mL, negative predictive value was 51.4%, positive predictive value was 94.6%, positive likelihood ratio was 4.04 (2.57-6.35), and negative likelihood ratio was 0.22 (0.09-0.54). Conclusion A strong, novel prospective association was identified between lower concentrations of soluble Fms-like kinase 1 and placental growth factor measured in early pregnancy and spontaneous abortion. A soluble Fms-like kinase 1 cut-off <742 pg/mL in maternal serum was optimal to stratify women at high vs low risk of spontaneous abortion. The cause and effect of angiogenic factor alterations in spontaneous abortions remain to be elucidated.
Pneumonia is a frequent lung infection and a serious illness, which is often diagnosed among patients hospitalized with acute exacerbations of COPD. The aim of this study was to estimate the ...attributable costs due to pneumonia among patients hospitalized with pneumonia compared to a matched general population control group without pneumonia hospitalization.
This study includes citizens older than 18 years from three municipalities (n=142,344). Based on national registers and municipal data, the health and social care costs of pneumonia in the second half of 2013 are estimated and compared with propensity score-matched population controls.
The average health care costs of 383 patients hospitalized with pneumonia in the second half of 2013 were US$34,561 per patient. Among pneumonia patients with COPD, the costs were US$35,022. The attributable costs of patients with pneumonia compared to the population control group for the 6-month period were US$24,155 per case. Overall, the attributable costs for the 383 pneumonia cases amounted to US$9.25 million. Subgroup analyses showed that costs increased with age. The attributable costs due to pneumonia were highest among the 18-59-year-old and the 70-79-year-old patients. This difference is likely to reflect an increased risk of mortality among the pneumonia patients. Men have higher costs than women in the pneumonia group.
The costs of pneumonia are considerable. In three Danish municipalities, the attributable costs due to pneumonia were US$24,155 per case or US$64,992 per 1,000 inhabitants in the second half of 2013. Similar high health care and social care costs were found for pneumonia patients with COPD - the largest group having pneumonia episodes. The municipalities are responsible for 49% of the costs, while a closer focus on the prevention of pneumonia may be advisable, eg, starting with citizens having COPD.
Research has indicated that cancer patients living in rural areas receive poorer quality of treatment and care than their urban counterparts. With a population of approximately 51,000, the Faroe ...Islands may be characterized as a small-scale, rural society. Due to the geographical location and size of the Faroe Islands, patients who live there often receive part of their treatment abroad. Although a shift in the focus of cancer care from a disease-focused approach to a person-centered approach has been successfully implemented elsewhere, legal and structural conditions unique to the Faroe Islands might prohibit the realization of this paradigmatic shift in the Faroe Islands. The aim of this qualitative study was to examine how Faroese cancer patients have experienced their disease, treatment, and care and provide additional knowledge on cancer patients living in small-scale and rural societies.
Five men and three women who had been through a cancer treatment course with a good prognosis volunteered to be interviewed. Their ages varied from 40 to 80 years. "Active interviewing", a constructionist approach to qualitative interviewing and latent thematic analysis, was applied.
Three overlapping themes were identified from the categories: sense of coherence, resources and challenges in everyday life, and trust in the system. The analysis uncovered multiple factors related to legal and structural conditions that were barriers to ensuring the quality of cancer care for patients, for instance, shifting consultants, a lack of coherence in treatment, information loss and insufficient contact with cancer nurse specialists.
This study is based on a limited number of participants. However, the findings from this study provide insight into the special conditions of cancer patients living in a small-scale, rural society and help explain disparities in the quality of cancer treatment and care between urban and rural areas.
Compared to the number of genes available for study of both younger and older divergences, few genes have yet been identified that can strongly resolve phylogenetic splits of Mesozoic age (∼65–250 ...mya). Thus, reconstruction of Mesozoic-age phylogenies, exemplified by basal divergences within the major orders of holometabolous insects, is likely to be especially dependent on combining multiple lines of evidence. This study tests the potential of the 18S ribosomal RNA gene for reconstructing Mesozoic-aged divergences within the insect order Lepidoptera and its ability when combined with a second, previously analyzed nuclear gene (phosphoenolpyruvate carboxykinase, PEPCK) to strongly resolve these relationships. 18S sequences were obtained for 21 taxa, representing major clades of Lepidoptera plus outgroups from the other “panorpoid” orders. A well-corroborated morphology-based “test phylogeny” was used to evaluate the effects of partitioning the 18S gene according to variable versus conserved domains, paired versus unpaired sites in the secondary structure, and transition versus transversion substitutions. Likelihood and unweighted parsimony analyses of the 18S data recover the “test phylogeny” almost completely, with no improvement of agreement or support provided by any form of weighting or partitioning. No conflict in signal between 18S and PEPCK was detected by the partition homogeneity test. Combined parsimony analysis yielded strong bootstrap support for nearly all relationships, much higher than for either gene alone, thereby also providing strong evidence on several hypotheses about the early evolution of lepidopteran–plant interactions. These genes in combination may be widely useful for resolving insect divergences of comparable age.
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