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  • Shapiro Kirkeby posted an update 1 week, 3 days ago

    In descending frequency, benefits identified were support in the community, integrated care, out-of-hours telephone advice, care home education and telemedicine. Nurses and hospices were central to many initiatives. Barriers and factors underpinning success were rarely addressed. CONCLUSIONS A wide range of initiatives have been introduced to improve end-of-life experiences. Formal evidence supporting their effectiveness in reducing inappropriate/non-beneficial hospital bed days was generally limited or absent. TRIAL REGISTRATION N/A.BACKGROUND The metabolic syndrome (MetS) has shown strong associations with the hypertriglyceridemic waist (HW) phenotype. The best anthropometric indicator of MetS remains controversial. Furthermore, no studies have investigated alternative indices that could replace waist circumference in the HW phenotype. The objectives of this study were to find the best indicator of MetS among anthropometric indices and to examine the predictive power of phenotypes consisting of triglyceride levels with anthropometric indices. METHODS A total of 12,025 subjects participated in this retrospective cross-sectional study. All subjects were recruited between November 2016 and August 2007 from hospitals in 28 urban and rural regions in South Korea. The data analyzed in this study were obtained from the Korean Health and Genome Epidemiology Study database and the Korea Institute of Oriental Medicine. RESULTS The proportion of patients with MetS ranged from 9 to 57% according to age and gender groups. Waist circumference (WC) was best indicator of MetS in men of all age groups. However, in women aged 40-49 years, the waist-to-height ratio (WHtR) was the best indicator of MetS. Rib circumference and chest circumference were the strongest indicators in women aged 50-59 years and 70-79 years, respectively. The combination of WC and triglyceride (TG) was the best indicator of MetS in men and women overall. However, interestingly, the best indicator was TG + WHtR in women aged 40-49 years and TG + forehead-to-waist ratio in women aged 70-79 years. RU.521 inhibitor CONCLUSIONS The best indicator of MetS in terms of individual anthropometric indices and the various phenotypes combining a single anthropometric index with TG may differ subtly according to age group in women, but not in men. Our findings provide insight into a simple and inexpensive method that could be used to identify MetS in initial health screening efforts in epidemiology and public health.BACKGROUND A long-term experiment at two trial sites in Kenya has been on-going since 2007 to assess the effect of organic and conventional farming systems on productivity, profitability and sustainability. During these trials the presence of significant numbers of termites (Isoptera) was observed. Termites are major soil macrofauna and within literature they are either depict as ‘pests’ or as important indicator for environmental sustainability. The extent by which termites may be managed to avoid crop damage, but improve sustainability of farming systems is worthwhile to understand. Therefore, a study on termites was added to the long-term experiments in Kenya. The objectives of the study were to quantify the effect of organic (Org) and conventional (Conv) farming systems at two input levels (low and high) on the abundance, incidence, diversity and foraging activities of termites. RESULTS The results showed higher termite abundance, incidence, activity and diversity in Org-High compared to Conv-High, Conv-Low and Org-Low. However, the termite presence in each system was also dependent on soil depth, trial site and cropping season. During the experiment, nine different termite genera were identified, that belong to three subfamilies (i) Macrotermitinae (genera Allodontotermes, Ancistrotermes, Macrotermes, Microtermes, Odontotermes and Pseudocanthotermes), (ii) Termitinae (Amitermes and Cubitermes) and (iii) Nasutitiermitinae (Trinervitermes). CONCLUSIONS We hypothesize that the presence of termites within the different farming systems might be influenced by the types of input applied, the soil moisture content and the occurrence of natural enemies. Our findings further demonstrate that the organic high input system attracts termites, which are an important, and often beneficial, component of soil fauna. This further increases the potential of such systems in enhancing sustainable agricultural production in Kenya.BACKGROUND The purpose of this study is to evaluate the prognostic factors for sperm retrieval and determine if Y chromosome deletion is associated with deleterious effects on spermatogenesis in non-mosaic Klinefelter patients. Whether Y chromosome deletion determines the sperm retrieval rate in non-mosaic Klinefelter patients has not yet been addressed. METHODS We retrospectively collected medical records of azoospermic patients from Sep 2009 to Dec 2018, and enrolled 66 non-mosaic 47, XXY patients who were receiving mTESE. The predictive values of patients age, serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, prolactin, estradiol and Y chromosome deletion were assessed for successful sperm recovery. RESULTS Testicular sperm recovery was successful in 24 (36.4%) of 66 men. The mean age (36.0 vs. 36.6 years), and levels of FSH (30.0 vs 36.9 IU/L), LH (17.7 vs 21.9 IU/L), testosterone (2.4 vs. 2.1 ng/ml), prolactin (9.1 vs. 8.8 ng/ml), and estradiol (19.4 vs. 22.3 pg/ml) did not show any significant difference when comparing patients with and without successful sperm retrieval. Partial deletion of azoospermic factor c (AZFc) was noted in 5 (20.8%) of 24 patients with successful sperm retrieval, including three b2/b3 and two gr/gr deletion cases, whereas 4 (9.5%) of 42 patients with unsuccessful sperm retrieval were noted to have AZFc partial deletion (one b2/b3, one sY1206 and two gr/gr deletion), though the difference was not statistically significant (p = 0.27). CONCLUSION According to present results, age and AZFc partial deletion status should not be a deterrent for azoospermic males with non-mosaic Klinefelter syndrome to undergo mTESE.

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