878 resultados para Accreditation: What It Is . . .and Is Not


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OBJECTIVES Although vitamin D is recognized as an important factor in bone health, its role in osteoarticular infections is unclear. We hypothesized that low vitamin D (25-hydroxycholecalciferol) levels are associated with a lower likelihood of treatment success in osteoarticular infections. METHODS This was a retrospective cohort study of patients with orthopedic infections who had a 25-hydroxycholecalciferol level drawn when their infection was diagnosed. Outcomes were determined at early (3-6 months) and late (6 months) follow-up after completing intravenous antibiotics. RESULTS We included 223 patients seen during an 11-month period with osteoarticular infections and baseline 25-hydroxycholecalciferol levels. During the initial inpatient management of the infection, hypovitaminosis D was identified and treated. The mean 25-hydroxycholecalciferol level was 2314ng/ml; 167 (75%) patients had levels <30ng/ml. Overall, infection treatment success was 91% (159/174) at early follow-up and 88% (145/164) at late follow-up. 25-Hydroxycholecalciferol baseline levels were similar in those with and without successful clinical outcomes, both at early (2515 vs. 219ng/ml; p=0.3) and late follow-up (2515 vs. 2316ng/ml; p=0.6). CONCLUSIONS To our knowledge this is the first report on hypovitaminosis D and its impact on outcomes of osteoarticular infections. Hypovitaminosis D was frequent in this cohort. With vitamin D repletion, there was no difference in treatment success whether patients had baseline hypovitaminosis or not.

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The uptake of silica (Si) and gold (Au) nanoparticles (NPs) engineered for laser-tissue soldering in the brain was investigated using microglial cells and undifferentiated and differentiated SH-SY5Y cells. It is not known what effects NPs elicit once entering the brain. Cellular uptake, cytotoxicity, apoptosis, and the potential induction of oxidative stress by means of depletion of glutathione levels were determined after NP exposure at concentrations of 10(3) and 10(9)NPs/ml. Au-, silica poly (-caprolactone) (Si-PCL-) and silica poly-L-lactide (Si-PLLA)-NPs were taken up by all cells investigated. Aggregates and single NPs were found in membrane-surrounded vacuoles and the cytoplasm, but not in the nucleus. Both NP concentrations investigated did not result in cytotoxicity or apoptosis, but reduced glutathione (GSH) levels predominantly at 6 and 24h, but not after 12 h of NP exposure in the microglial cells. NP exposure-induced GSH depletion was concentration-dependent in both cell lines. Si-PCL-NPs induced the strongest effect of GSH depletion followed by Si-PLLA-NPs and Au-NPs. NP size seems to be an important characteristic for this effect. Overall, Au-NPs are most promising for laser-assisted vascular soldering in the brain. Further studies are necessary to further evaluate possible effects of these NPs in neuronal cells.

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In dairy cows, milk yield increases rapidly after parturition until a peak at around wk 6 of lactation. However, the description of the shape of the lactation curve is commonly based on weekly average milk yields. For a more detailed analysis of the milk production curve from the very beginning of lactation including the colostral period and the effect of colostrum yield on further lactational performance, the first 10 milkings after parturition, daily milk yields from d 1 to 28 of lactation, and the cumulative milk production on d 100 to 305 of lactation were investigated in 17 primiparous and 39 multiparous cows milked twice daily. Milk yield at the first milking after parturition (colostrum) ranged from 1.3 to 20.7kg (=19.4kg) in multiparous and from 1.8 to 10.9kg in primiparous animals (=9.1kg). At the tenth milking, milk production ranged from 9.2 to 21.5kg (=12.3kg) in multiparous and from 7.0 to 15.2kg (=8.2kg) in primiparous animals. Immediately after parturition, daily milk production increased rapidly, but after approximately 1wk in lactation, the slope of the daily milk production curve flattened and continued more linear. A nonlinear regression equation was used to determine this timely change, which occurred earlier in primiparous (d 6.90.3) than in multiparous cows (d 8.20.2). The correlation between the amount of first colostrum and milk production during further lactation decreased already from 0.47 on d 5 to 0.32 on d 14. In multiparous cows, the correlation between total milk production of the previous 305d standard lactation and the amount of first colostrum was not significant (correlation=0.29), whereas the correlation with the daily production increased from 0.45 on d 5 to 0.69 on d 14. However, in primiparous animals, correlations between first-colostrum yield and daily milk yields up to d 28 of lactation were not significant, possibly due to the smaller sample size compared with multiparous animals. First-colostrum yield and cumulative milk production of 100, 200, and 305 lactation days were not significantly correlated in multiparous and primiparous cows. In conclusion, the milk production during the first few milkings is widely independent from the overall production level of a cow. Potentially, genetic selection toward lower milk yield during the very first days after parturition at a simultaneously high lactational performance may be a tool to ensure sufficient colostrum quality and to reduce the metabolic load around parturition.

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Performance on interval timing is often explained by the assumption of an internal clock based on neural counting. According to this account, a neural pacemaker generates pulses, and the number of pulses relating to a physical time interval is recorded by a counter. Thus, the number of accumulated pulses is the internal representation of this interval. Several studies demonstrated that large visual stimuli are perceived to last longer than smaller ones presented for the same duration. The present study was designed to investigate whether nontemporal visual stimulus size directly affects the internal clock. For this purpose, a temporal reproduction task was applied. Sixty participants were randomly assigned to one of two experimental conditions with stimulus size being experimentally varied within either the target or the reproduction interval. A direct effect of nontemporal stimulus size on the pacemaker-counter system should become evident irrespective of whether stimulus size was experimentally varied within the target or the reproduction interval. An effect of nontemporal stimulus size on reproduced duration only occurred when stimulus size was varied during the target interval. This finding clearly argues against the notion that nontemporal visual stimulus size directly affects the internal clock. Furthermore, our findings ruled out a decisional bias as a possible cause of the observed differential effect of stimulus size on reproduced duration. Rather the effect of stimulus size appeared to originate from the memory stage of temporal information processing at which the timing signal from the pacemaker-counter component is encoded in reference memory.

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Endozoochory is an important dispersal mechanism for seed plants and has recently been demonstrated to occur also in spore plants, such as ferns, which are commonly consumed by herbivores. However, it is not known whether fern species from particular habitats are differentially preferred by herbivores and whether their spores differ in their ability to survive the gut passage of herbivores. Such differences would suggest adaptation to endozoochorous dispersal, as it is known for seed plants. Moreover, it is unclear whether herbivore species differ in their efficiency to disperse fern spores. In a factorial experiment, we fed fertile leaflets of 13 fern species from different forest and open habitats to three polyphagous herbivore species and recorded the germination of spores from feces after 46 and 81 days. Fern spores germinated in 66 % of all samples after 46 days. At this stage, germination success differed among fern and herbivore species, but was independent of the ferns habitat. Interestingly, after 81 days fern spores germinated in 85 % of all samples and earlier significant differences in germination success among fern and herbivore species were not sustained. The overall high germination success and the absence of differences among fern species from different habitats together with the consistency across three tested herbivores strongly imply endozoochorous dispersal to be a taxonomically widespread phenomenon among fern-eating herbivores, which all might act as potential dispersal vectors. 2015, Springer Science+Business Media Dordrecht.

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BACKGROUND Deep brain stimulation (DBS) is recognized as an effective treatment for movement disorders. We recently changed our technique, limiting the number of brain penetrations to three per side. OBJECTIVES The first aim was to evaluate the electrode precision on both sides of surgery since we implemented this surgical technique. The second aim was to analyse whether or not the electrode placement was improved with microrecording and macrostimulation. METHODS We retrospectively reviewed operation protocols and MRIs of 30 patients who underwent bilateral DBS. For microrecording and macrostimulation, we used three parallel channels of the 'Ben Gun' centred on the MRI-planned target. Pre- and post-operative MRIs were merged. The distance between the planned target and the centre of the implanted electrode artefact was measured. RESULTS There was no significant difference in targeting precision on both sides of surgery. There was more intra-operative adjustment of the second electrode positioning based on microrecording and macrostimulation, which allowed to significantly approach the MRI-planned target on the medial-lateral axis. CONCLUSION There was more electrode adjustment needed on the second side, possibly in relation with brain shift. We thus suggest performing a single central track with electrophysiological and clinical assessment, with multidirectional exploration on demand for suboptimal clinical responses.

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Vestibular cognition has recently gained attention. Despite numerous experimental and clinical demonstrations, it is not yet clear what vestibular cognition really is. For future research in vestibular cognition, adopting a computational approach will make it easier to explore the underlying mech- anisms. Indeed, most modeling approaches in vestibular science include a top-down or a priori component. We review recent Bayesian optimal observer models, and discuss in detail the conceptual value of prior assumptions, likelihood and posterior estimates for research in vestibular cognition. We then consider forward models in vestibular processing, which are required in order to distinguish between sensory input that is induced by active self-motion, and sensory input that is due to passive self-motion. We suggest that forward models are used not only in the service of estimating sensory states but they can also be drawn upon in an offline mode (e.g., spatial perspective transformations), in which interaction with sensory input is not desired. A computational approach to vestibular cogni- tion will help to discover connections across studies, and it will provide a more coherent framework for investigating vestibular cognition.

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Studies suggest that depression affects glucose metabolism, and therefore is a risk factor for insulin resistance. The association between depression and insulin resistance has been investigated in a number of studies, but there is no agreement on the results. The objective of this study is to survey the epidemiological studies, identify the ones that measured the association of depression (as exposure) with insulin resistance (as outcome), and perform a systematic review to assess the reliability and strength of the association. For high quality reporting, and assessment, this systematic review used the outlined procedures, guidelines and recommendations for reviews in health care, suggested by the Centre for Reviews and Dissemination, along with recommendations from the STROBE group (Strengthening the Reporting of Observational Studies in Epidemiology). Ovid MEDLINE 1996 to April Week 1 2010, was used to identify the relevant epidemiological studies. To identify the most relevant set of articles for this systematic review, a set of inclusion and exclusion criteria were applied. Six studies that met the specific criteria were selected. Key information from identified studies was tabulated, and the methodological quality, internal and external validity, and the strength of the evidence of the selected studies were assessed. The result from the tabulated data of the reviewed studies indicates that the studies either did not apply a case definition for insulin resistance in their investigation, or did not state a specific value for the index used to define insulin resistance. The quality assessment of the reviewed studies indicates that to assess the association between insulin resistance and depression, specifying a case definition for insulin resistance is important. The case definition for insulin resistance is defined by the World Health Organization and the European Group for the Study of Insulin Resistance as the insulin sensitivity index of the lowest quartile or lowest decile of a general population, respectively. Three studies defined the percentile cut-off point for insulin resistance, but did not give the insulin sensitivity index value. In these cases, it is not possible to compare the results. Three other studies did not define the cut-off point for insulin resistance. In these cases, it is hard to confirm the existence of insulin resistance. In conclusion, to convincingly answer our question, future studies need to adopt a clear case definition, define a percentile cut-off point and reference population, and give value of the insulin resistance measure at the specified percentile.^

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This research addressed the question of life satisfaction for retired and employed women with long-term employment in a typically female occupational setting. Questions of how women's retirement is related to life satisfaction have been largely neglected because of cultural assumptions about the relative unimportance of the work role in women's lives. It is generally believed that the major source of satisfaction for women is in traditional family roles. Therefore, it follows that retirement from work is not experienced as a loss for women.^ The actual consequences of women's retirement have not been examined systematically. Descriptive data about their lives are inadequate. It is not known what patterns and resources result from a lifetime of work for women.^ The objectives of the study were to test assumptions from role and continuity theory regarding life satisfaction for retired women and women employed late in life and to describe the retirement and work experiences of the women.^ Life satisfaction was measured by the Neugarten, Havighurst and Tobin Life Satisfaction Index. Perceptions of appropriate roles for females and males were assessed through an attitudinal sex-role instrument. A composite index, derived from perceptions of health, social participation, and income at two time periods, measured level of continuity. These indices and demographic information, attitudinal items about work and retirement, and social network data comprised the mailed, self-administered survey and the personal interviews.^ The study population included 91 retired and 53 employed women, 55 years or older with a minimum of 20 years continuous employment, who were enrolled in the pension program of a large retail store.^ The retired women's perceptions of their health and social participation were more positive than the employed women's. Traditional retired women demonstrated higher life satisfaction than nontraditional retired women. Both retired and employed women who perceived continuity in life patterns scored statistically higher on life satisfaction than women who perceived discontinuity. Financial planning was the area of greatest retirement concern for retired and employed women.^

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A cloned nontumorigenic prostatic epithelial cell line, NbE-1.4, isolated from Noble (nbl/crx) rat ventral prostate, was used to examine the potential role of activated myc and neu oncogenes in prostate carcinogenesis. Transfection of SV40 promoter/enhancer driven constructs containing either v-myc, truncated c-myc, or neu-T (activated neu) oncogenes was accomplished using calcium phosphate-mediated DNA transfer. Cells were cotransfected, as necessary, with pSV2neo, allowing for selection of positive clones using the antibiotic geneticin (G418). G418 resistant colonies were pooled in some cases or limiting dilution exclusion cloned in others as described. Transfection of NbE-1.4 cells with activated myc oncogenes resulted only in the partial transformation. These cells display an altered morphology and decreased dependence on serum factors in vitro; however, saturation density, soft agar colony formation and growth assay in male athymic nude mice were all negative. Transfection and overexpression of NbE-1.4 cells with an activated neu oncogene alone resulted in tumorigenic conversion. Cell transformation was evident following an examination of the altered cellular morphology, an increased soft agar colony formation, and an acquisition of a tumorigenic potential when injected s.c. into male athymic nude mice. neu-transformed NbE-1.4 cells displayed elevated activity of the neu receptor tyrosine kinase. Furthermore, qualitative changes in tyrosine phosphorylated proteins were found in neu transformed cell clones. These changes were associated with elevated expression of mRNAs for laminin $\beta$1, $\beta$2, and procollagen type IV. The expression of fibronectin and E-cadherin, which are often lost during tumorigenesis, did not correlate with the tumorigenic phenotype. Therefore, it appears that neu oncogene overexpression has been found to be associated with the transformation of rat prostatic epithelial cells, presumably through alterations in gene expression that regulate extracellular matrix. The possible interrelationship and functional significance between neu oncogene expression and the elevated extracellular matrix gene expression is discussed. ^

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Siliciclastic sedimentation at Ocean Drilling Program Site 1017 on the southern slope of the Santa Lucia Bank, central California margin, responded closely to oceanographic and climatic change over the past ~130 ka. Variation in mean grain-size and sediment sorting within the ~25-m-thick succession from Hole 1017E show Milankovitch-band to submillenial-scale variation. Mean grain size of the "sortable silt" fraction (10-63 m) ranges from 17.6 to 33.9 m (average 24.8 m) and is inversely correlated with the degree of sorting. Much of the sediment has a bimodal or trimodal grain-size distribution that is composed of distinct fine silt, coarse silt to fine sand, and clay-size components. The position of the mode and the sorting of each component changes through the succession, but the primary variation is in the presence or abundance of the coarse silt fraction that controls the overall mean grain size and sorting of the sample. The occurrence of the best-sorted, finest grained sediment at high stands of sea level (Holocene, marine isotope Substages 5c and 5e) reflect the linkage between global climate and the sedimentary record at Site 1017 and suggest that the efficiency of off-shelf transport is a key control of sedimentation on the Santa Lucia Slope. It is not clear what proportion of the variation in grain size and sorting may also be caused by variations in bottom current strength and in situ hydrodynamic sorting.

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Increased oceanic uptake of atmospheric carbon dioxide (CO2) is a threat to marine organisms and ecosystems. Among the most dramatic consequences predicted to date are behavioural impairments in marine fish which appear to be caused by the interference of elevated CO2 with a key neurotransmitter receptor in the brain. In this study, we tested the effects of elevated CO2 on the foraging and shelter-seeking behaviours of the reef-dwelling epaulette shark, Hemiscyllium ocellatum. Juvenile sharks were exposed for 30 d to control CO2 (400 atm) and two elevated CO2 treatments (615 and 910 atm), consistent with medium- and high-end projections for ocean pCO2 by 2100. Contrary to the effects observed in teleosts and in some other sharks, behaviour of the epaulette shark was unaffected by elevated CO2. A potential explanation is the remarkable adaptation of H. ocellatum to low environmental oxygen conditions (hypoxia) and diel fluctuations in CO2 encountered in their shallow reef habitat. This ability translates into behavioural tolerance of near-future ocean acidification, suggesting that behavioural tolerance and subsequent adaptation to projected future CO2 levels might be possible in some other fish, if adaptation can keep pace with the rate of rising CO2 levels.

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Air-fall volcanic ash and pumice were recovered from 22 intervals in upper Miocene-Pleistocene nannofossil oozes cored in Hole 810C on Shatsky Rise, northwest Pacific. Shatsky Rise is near the eastern limit of ash falls produced by explosive volcanism in arc systems in northern Japan and the Kuriles, more than 1600 km away. Electron probe analyses establish that the ash beds and pumice pebbles are andesitic to rhyolitic in composition, and belong to both tholeiitic and high-alumina lineages similar to tephra from Japanese volcanoes. High-speed winds in the polar-front and subtropical jets are evidently what propelled the ash for such a distance. The pumice arrived by flotation, driven from the same directions by winds, waves, and currents. It is not ice-rafted debris from the north. One thick pumice bed probably was deposited when a large pumice mat passed over Shatsky Rise. Far more abundant ash occurs in sediments cored at DSDP Sites 578 through 580, about 500 km west of Shatsky Rise. Most of the ash and pumice at Shatsky Rise can be correlated with specific ash beds at 1, 2, or all 3 of these sites by interpolating to precisely determined magnetic reversal sequences in the cores. Most of the correlations are to thick ash layers (5.7 +/- 3.0 cm) at one or more sites. These must represent extremely large eruptions that spread ash over very wide areas. Whereas several of the thicker correlative ashes fell from elongate east-trending plumes directed from central Japan, the majority of them - dating from about 2 Ma - came from the North Honshu and Kurile arc systems to the northwest. This direction probably was in response to both long-term and seasonal fluctuations in the location and velocity of the polar-front jet, and to more vigorous winter storm fronts originating over glaciated Siberia.

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Ocean acidification is thought to be a major threat to coral reefs: laboratory evidence and CO2 seep research has shown adverse effects on many coral species, although a few are resilient. There are concerns that cold-water corals are even more vulnerable as they live in areas where aragonite saturation (Omega ara) is lower than in the tropics and is falling rapidly due to CO2 emissions. Here, we provide laboratory evidence that net (gross calcification minus dissolution) and gross calcification rates of three common cold-water corals, Caryophyllia smithii, Dendrophyllia cornigera, and Desmophyllum dianthus, are not affected by pCO2 levels expected for 2100 (pCO2 1058 atm, Omega ara 1.29), and nor are the rates of skeletal dissolution in D. dianthus. We transplanted D. dianthus to 350 m depth (pHT 8.02; pCO2 448 atm, Omega ara 2.58) and to a 3 m depth CO2 seep in oligotrophic waters (pHT 7.35; pCO2 2879 atm, Omega ara 0.76) and found that the transplants calcified at the same rates regardless of the pCO2 confirming their resilience to acidification, but at significantly lower rates than corals that were fed in aquaria. Our combination of field and laboratory evidence suggests that ocean acidification will not disrupt cold-water coral calcification although falling aragonite levels may affect other organismal physiological and/or reef community processes.