Dysphagia is a prevalent disorder in acute geriatric patients. This observational prospective study aimed at investigating adverse clinical outcomes linked to signs of dysphagia, including mortality, ...length of hospital stay (LOS), readmissions, among patients aged ≥ 65 years at a Danish acute medical unit (AMU).
Signs of dysphagia were assessed using bedside screening tools including the Eating Assessment Tool (EAT-10), a 30 mL Water Swallowing Test (WST) and the Gugging Swallowing Screen tool (GUSS), as described in the preceding cross-sectional study. Data for the follow-up was twice retrieved from electronic medical charts 30 days and 90 days after the patients’ primary admission to the hospital. Statistical analysis included non-parametric tests of independence and proportional hazards modelling.
444 patients were recruited, 334 of whom completed the dysphagia screening with 144 (43.1 %) showing signs of dysphagia. Patients with signs of dysphagia, compared to those without, experienced higher mortality after 30 days (12.5 % vs. 1.6 %, p < 0.001) and 90 days (21.5 % vs. 5.8 %, p < 0.001), longer LOS (median Q1; Q3: 4 2; 8 vs. 3 1; 6 days, p = 0.004), more total hospital days (THD) during both the 30-day and 90-day follow-up (for 90d: median Q1; Q3: 6 2.25; 12 vs. 4 2; 9 days, p = 0.007), but no significant difference in frequency of readmissions. Multivariate proportional hazards modelling revealed signs of dysphagia, low performance status and high comorbidity to be independent risk factors for mortality. High comorbidity and low hemoglobin, but not signs of dysphagia, were revealed as independent risk factors for readmission.
Dysphagia is a notable risk factor linked to increased mortality and length of hospital stay (LOS) for acute geriatric patients in general, not just those suffering from stroke, head and neck cancer or neurodegenerative diseases. Further research is needed to investigate the effectiveness and feasibility of systematic dysphagia screening within this population.
The cocoa industry in Ghana is the second largest in the world, and it generates huge amounts of cocoa pod husks, which currently represent a disposal problem as no significant use has been found for ...them. The husks are rich in potassium, which may be used for alkaline hydrocolloid extraction from red seaweeds. Chemical and rheological properties of κ-carrageenan from
Kappaphycus alvarezii
and the Ghanaian red seaweed
Hypnea musciformis
extracted by KOH (benchmark) or by a cocoa pod husk ash solution were compared. Similar extraction yields and successful modification of the seaweed hydrocolloids with 3,6-anhydro-galactopyranose and sulfate contents of 37–38 and 16–17%, respectively, were obtained with cocoa pod husk ash and KOH extraction. Gel strengths of the κ-carrageenans were also similar: G′ at 25 °C were 5780 Pa with cocoa pod husk ash and 5930 Pa with KOH. These findings have implications for industrial waste biomass utilization and sustainable green growth development of seaweed hydrocolloid processing in Ghana.
The quality of Earth observation (EO) based vegetation monitoring has improved during recent years, which can be attributed to the enhanced sensor design of new satellites such as MODIS (Moderate ...Resolution Imaging Spectroradiometer) on Terra and Aqua. It is however expected that sun-sensor geometry variations will have a more visible impact on the Normalized Difference Vegetation Index (NDVI) from MODIS compared to earlier data sources, since noise related to atmosphere and sensor calibration is substantially reduced in the MODIS data stream. For this reason, the effect of varying MODIS viewing geometry on red, near-infrared (NIR) and NDVI needs to be quantified. Data from the geostationary MSG (Meteosat Second Generation) SEVIRI (Spinning Enhanced Visible and Infrared Imager) sensor is well suited for this purpose due to the fixed position of the sensor, the spectral resolution, including a red and NIR band, and the high temporal resolution (15 min) of data, enabling MSG data to be used as a reference for estimating MODIS surface reflectance and NDVI variations caused by varying sun-sensor geometry. The study was performed on data covering West Africa for periods of lowest possible cloud cover for three consecutive years (2004-2006). An analysis covering the entire range of NDVI revealed day-to-day variations in observed MODIS NDVI of 50-60% for medium dense vegetation (NDVI ≈ 0.5) caused by variations in MODIS view zenith angles (VZAs) between nadir and the high forward-scatter view direction. Statistical analysis on red, NIR and NDVI from MODIS and MSG SEVIRI for three transects (characterized by different vegetation densities) showed that both MODIS red and NIR reflectances are highly dependant on MODIS VZA and relative azimuth angle (RAA), due to the anisotropic behaviour of red and NIR reflectances. The anisotropic reflectance in the red and NIR band was to some degree minimized by the ratioing properties of NDVI. The minimization by the NDVI normalization is very dependent on the vegetation density however, since the degree of anisotropy in red and NIR reflectances depends on the amount of vegetation present. MODIS VZA and RAA effects on NDVI were highest for medium dense vegetation (NDVI ≈ 0.5-0.6). The VZA and RAA effects were less for sparsely vegetated areas (NDVI ≈ 0.3-0.35) and the smallest effect on NDVI was found for dense vegetation (NDVI ≈ 0.7). These results have implications for the end users' interpretation of NDVI, and challenge the expediency of the MODIS NDVI compositing technique, which should be refined to distinguish between forward- and backward-scatter viewing direction by taking RAA into account.
Porcine Reproductive and Respiratory Syndrome Virus (PRRSV) is the causative agent of one of the most important porcine diseases with a high impact on animal health, welfare, and production economy. ...PRRSV exhibits a multitude of immunoevasive strategies that, in combination with a very high mutation rate, has hampered the development of safe and broadly protective vaccines. Aiming at a vaccine inducing an effective cytotoxic T cell response, a bioinformatics approach was taken to identify conserved PRRSV-derived peptides predicted to react broadly with common swine leukocyte antigen (SLA) class I alleles. Briefly, all possible 9- and 10-mer peptides were generated from 104 complete PRRSV type 2 genomes of confirmed high quality, and peptides with high binding affinity to five common SLAs were identified combining the NetMHCpan and positional scanning combinatorial peptide libraries binding predictions. Predicted binders were prioritized according to genomic conservation and SLA coverage using the PopCover algorithm. From this, 53 peptides were acquired for further analysis. Binding affinity and stability of a subset of 101 peptide-SLA combinations were validated in vitro for 4 of the 5 SLAs. Eventually, 23% of the predicted peptide-SLA combinations showed to form complexes with a dissociation half-life ≥30 min. Additionally, combining the two prediction methods proved to be more robust across alleles than either method used alone in terms of predicted-to-observed correlations. In summary, our approach represents a finely tuned epitope prediction pipeline providing a rationally selected ensemble of peptides for future in vivo experiments with pigs expressing the included SLAs.
Woody vegetation dynamics in the Sahel have been debated since the great droughts of the 1970s–1980s. Here, we combined high-resolution satellite and aerial imagery, field inventory, and historical ...botanical records to study woody vegetation trends over the years 1965, 1980, 2008, and 2018 in the Ferlo, the Sahelian sylvo-pastoral zone of Senegal. While tree density has decreased from 1965 (14.8 trees ha
−1
) to 1980 (13.4 trees ha
−1
) and 2008 (11.9 trees ha
−1
), tree density has stabilized in 2018 (12.2 trees ha
−1
). The relatively moderate decrease in tree density over 50 years characterized by extensive human pressure and droughts, as well as the rather stable woody cover following the drought years after the 1980s, do not support narratives of widespread desertification in this region. However, we observed a shift in the composition of species. While the drought-resistant tree
Balanites aegyptiaca
showed a stable abundance,
Acacia tortilis
showed strong increases and other species like
Sclerocarya birrea
and
Combretum glutinosum
decreased. In addition, recent field surveys show that the ratio between shrubs and trees has increased towards more shrubs. The observed loss of species diversity combined with the increase of drought-resistant species is in line with current observations for savanna ecosystems in the context of an increased aridity.
The technically easier one-anastomosis (mini) gastric bypass (MGB) is associated with similar metabolic improvements and weight loss as the Roux-en-Y gastric bypass (RYGB). However, MGB is ...controversial and suspected to result in greater malabsorption than RYGB. In this study, we compared macronutrient absorption and intestinal adaptation after MGB or RYGB in rats. Body weight and food intake were monitored and glucose tolerance tests were performed in rats subjected to MGB, RYGB, or sham surgery. Carbohydrate, protein, and lipid absorption was determined by fecal analyses. Intestinal remodeling was evaluated by histology and immunohistochemistry. Peptide and amino acid transporter mRNA levels were measured in the remodeled intestinal mucosa and those of anorexigenic and orexigenic peptides in the hypothalamus. The MGB and RYGB surgeries both resulted in a reduction of body weight and an improvement of glucose tolerance relative to sham rats. Hypothalamic orexigenic neuropeptide gene expression was higher in MGB rats than in RYGB or sham rats. Fecal losses of calories and proteins were greater after MGB than RYGB or sham surgery. Intestinal hyperplasia occurred after MGB and RYGB with increased jejunum diameter, higher villi, and deeper crypts than in sham rats. Peptidase and peptide or amino acid transporter genes were overexpressed in jejunal mucosa from MGB rats but not RYGB rats. In rats, MGB led to greater protein malabsorption and energy loss than RYGB. This malabsorption was not compensated by intestinal overgrowth and increased expression of peptide transporters in the jejunum.
Baleen whales are key consumers in marine ecosystems and can serve as ecosystem sentinels. Body condition, defined as an individual’s energy stores relative to its structural size, can provide a ...useful proxy for health in baleen whales. As capital breeders, important life history events in baleen whales such as seasonal migrations and reproduction depend on having sufficient energy stores. Spatiotemporal variability of body condition of baleen whales can reflect differences in energy accumulated during the foraging season. Here we assess and compare the body condition and mass of humpback whales ( Megaptera novaeangliae) across four different foraging areas from the West Indies distinct population segment in the Northwest Atlantic. Morphometric measurements of humpback whales were obtained using unoccupied aerial systems (UAS, or drones) from the New York Bight, the Gulf of Maine, Iceland, and Greenland. Uncertainty in morphometric estimates was incorporated and propagated using a bootstrapping approach. Measurements were used to estimate body volume and calculate a body condition index (BCI) for each individual whale. Since body mass is a key parameter for understanding animal physiology and bioenergetics, we further compared whale body mass to body size between foraging areas by converting body volume to body mass using estimates of tissue density from tagging studies. BCI showed significant differences between foraging areas with a large effect size (ANCOVA: mean η 2 = 0.168; all p< 0.001) when incorporating day of year and year as covariates. Humpback whales in the Gulf of Maine showed significantly higher BCI than those in the New York Bight, Iceland, and Greenland. Standardized Major Axis (SMA) regressions comparing log-log relationships of both body volume and body mass, respectively, to total length reinforced these results. Humpback whales in the Gulf of Maine showed significantly higher elevation in the SMAs than those in the other study regions (p<0.001), implying that humpback whales foraging in the Gulf of Maine accumulated greater energy reserves for a given body size. Estimates of body mass indicate that for a given body length, humpback whales in the Gulf of Maine have an 18% greater body mass than those in the New York Bight, Iceland, or Greenland. Regional differences in prey availability or anthropogenic threats could contribute to the observed patterns in body condition. Our findings highlight the importance of regional environmental factors to the nutritional health of baleen whales.
A century of trends in adult human height Bentham, James; Di Cesare, Mariachiara; Stevens, Gretchen A. ...
eLife,
07/2016, Letnik:
5, Številka:
2016JULY
Journal Article
Recenzirano
Odprti dostop
Being taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants ...to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.5-22.7) and 16.5 cm (13.3- 19.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8- 144.8). The height differential between the tallest and shortest populations was 19-20 cm a century ago, and has remained the same for women and increased for men a century later despite substantial changes in the ranking of countries.
Two piston cores, DS97-2P from the Reykjanes Ridge in the central North Atlantic Ocean (1685 m water depth) and ENAM33 from southwest of the Faeroe Islands in the NE Atlantic (1217 m water depth), ...have been investigated for their planktic and benthic foraminiferal content. DS97-2P is situated near the Subarctic Front and productivity measured by accumulation rates of benthic and planktic foraminifera has been generally high during the Holocene. The productivity shows a clear decrease from an early Holocene maximum to a late Holocene minimum. Coeval changes in the benthic faunas indicate that the food supply changed from large, irregular pulses during the early Holocene to a more sustained flux during the late Holocene. Presumably in concert with decreasing bottom current activity oxygen conditions in the bottom water became poorer. Another feature of the late Holocene is an increasing instability of the North Atlantic thermohaline circulation regime. Nevertheless, the changes in faunal composition and productivity during the Holocene were gradual as compared to the discontinuous distribution patterns and abrupt productivity shifts during the glacial. The glacial shifts were on a millennial time scale and correlate with the interstadial–stadial phases of the Dansgaard–Oeschger cycles in the Greenland ice cores. The faunas of the warm interstadial phases resembled the Holocene faunas, and both surface and bottom productivity was high. The faunas suggest that the interstadial circulation pattern was very similar to the modern system with convection in the Nordic seas and generation of North Atlantic Deep Water. The planktic faunas during the cold stadials and Heinrich events were completely dominated by the polar species
Neogloboquadrina pachyderma s, and surface conditions were cold and the productivity low. The benthic faunas were dominated by species that presently thrive in areas with a low amount of food and reduced oxygen content. The water column was probably stratified with low saline, cold surface water overlying poorly aerated, intermediate water masses.
This article reviews fellowship training in adult cardiac, thoracic, and vascular anesthesia and critical care from the perspective of European program initiators and educational leaders in these ...subspecialties together with current training fellows. Currently, the European Association of Cardiothoracic Anaesthesiology (EACTA) network has 20 certified fellowship positions each year in 10 hosting centers within 7 European countries, with 2 positions outside Europe (São Paulo, Brazil). Since 2009, 42 fellows have completed the fellowship training. The aim of this article is to provide an overview of the rationale, requirements, and contributions of the fellows, in the context of the developmental progression of the EACTA fellowship in adult cardiac, thoracic, and vascular anesthesia and critical care from inception to present. A summary of the program structure, accreditation of host centers, requirements to join the program, teaching and assessment tools, certification, and training requirements in transesophageal electrocardiography is outlined. In addition, a description of the current state of EACTA fellowships across Europe, and a perspective for future steps and challenges to the educational program, is provided.
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