1,467 research outputs found

    Antibiotic-induced disturbances of the gut microbiota result in accelerated breast tumor growth

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    The gut microbiota\u27s function in regulating health has seen it linked to disease progression in several cancers. However, there is limited research detailing its influence in breast cancer (BrCa). This study found that antibiotic-induced perturbation of the gut microbiota significantly increases tumor progression in multiple BrCa mouse models. Metagenomics highlights the common loss of several bacterial species following antibiotic administration. One such bacteria

    A Cost Analysis of Carpal Tunnel Release Surgery Performed Wide Awake versus under Sedation.

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    BACKGROUND: Hand surgery under local anesthesia only has been used more frequently in recent years. The purpose of this study was to compare perioperative time and cost for carpal tunnel release performed under local anesthesia ( wide-awake local anesthesia no tourniquet, or WALANT) only to carpal tunnel release performed under intravenous sedation. METHODS: A retrospective comparison of intraoperative (operating room) surgical time and postoperative (postanesthesia care unit) time for consecutive carpal tunnel release procedures performed under both intravenous sedation and wide-awake local anesthesia was undertaken. All operations were performed by the same surgeon using the same mini-open surgical technique. A cost analysis was performed by means of standardized anesthesia billing based on base units, time, and conversion rates. RESULTS: There were no significant differences between the two groups in terms of total operative time, 28 minutes in the intravenous sedation group versus 26 minutes in the wide-awake local anesthesia group. Postanesthesia care unit times were significantly longer in the intravenous sedation group (84 minutes) compared to the wide-awake local anesthesia group (7 minutes). Depending on conversion rates used, a total of 139to139 to 432 was saved in each case performed with wide-awake local anesthesia by not using anesthesia services. In addition, a range of 1320to1320 to 1613 was saved for the full episode of care, including anesthesia costs, operating room time, and postanesthesia care unit time for each patient undergoing wide-awake local anesthesia carpal tunnel release. CONCLUSION: Carpal tunnel release surgery performed with the wide-awake local anesthesia technique offers significant reduction in cost for use of anesthesia and postanesthesia care unit resources

    Outcomes for continuous subcutaneous insulin infusion users in young adults from lower socioeconomic backgrounds

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    OBJECTIVE: Diabetes technology is available and its efficacy and safety have been demonstrated; however, there is little evidence as to how this technology is being utilized and its effectiveness in vulnerable populations. This study evaluated differences in outcomes for young adults in the United States (U.S.) from lower socioeconomic (SES) backgrounds with type 1 diabetes (T1D) managed on continuous subcutaneous insulin infusion (CSII) versus multiple daily injections (MDI) or fixed-dose insulin (FDI). RESEARCH DESIGN METHODS AND PARTICIPANTS: Utilizing the Optum® de-identified Electronic Health Record data set between 2008 and 2018 to perform a retrospective, cohort study, we identified 805 subjects with T1D aged 18-30 years with Medicaid. We evaluated median difference in HbA1c between CSII and MDI/FDI users for 24 months. Predictors of diabetic ketoacidosis (DKA)-associated hospitalizations by CSII use were evaluated using logistic regression. RESULTS: CSII users showed statistically significant lower median HbA1c values at 24 months of follow-up compared to individuals on MDI/FDI. Non-white individuals were at lower odds of receiving treatment with CSII. Subjects on CSII were not more likely to be hospitalized for DKA compared to subjects treated with MDI/FDI. Older subjects were at lower odds of being hospitalized for DKA. Males and subjects followed by Endocrinologists were at higher odds of being hospitalized for DKA. CONCLUSIONS: Young adults with T1D from lower SES backgrounds show improved glycaemic control when in CSII compared to MDI/FDI without increases in hospitalizations for DKA

    The United Nations Basic Space Science Initiative: The TRIPOD concept

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    Since 1990, the United Nations is annually holding a workshop on basic space science for the benefit of the worldwide development of astronomy. Additional to the scientific benefits of the workshops and the strengthening of international cooperation, the workshops lead to the establishment of astronomical telescope facilities through the Official Development Assistance (ODA) of Japan. Teaching material, hands-on astrophysics material, and variable star observing programmes had been developed for the operation of such astronomical telescope facilities in an university environment. This approach to astronomical telescope facility, observing programme, and teaching astronomy has become known as the basic space science TRIPOD concept. Currently, a similar TRIPOD concept is being developed for the International Heliophysical Year 2007, consisting of an instrument array, data taking and analysis, and teaching space science.Comment: 8 pages, LaTe

    Economic Evaluation of Conservation Concepts for Municipal Water Systems

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    Five concepts for conservation of municipal water supply are analyzed from an economic efficiency perspectice. They include: 1) seasonal pricing (for reduction of peak period water use), 2) dual water systems (separate high quality drinking water and untreated outdoor irrigation systems), 3) imported water transmission facility capacity optimization, 4) flow restricting devices, and 5) short-term rationing concepts. Optimization models, including generalized model generators, were developed for analysis of the first three concepts and demonstrated by applications to cities in Utah. The flow restricting device and short-term rationsing concept analyses applied approaches taken from the literature to example sites in Utah. The final chapter is a comparison of results and summary of conditions which favor each approach to conservation. Conclusions include: Seasonal pricing was demonstarted to reduce peak period water use but is not justified in Salt Lake City because the added cost of metering exceeds the additional benefits. Dual water systems are potentially an important concept for matching various qualities of water with appropriate uses and producing net economic benefits. Determination of capacity of an imported water facility is dominated more by the decision maker\u27s attitude toward risk than by pricing policy. Flow restricting devices produce economic benefits only if the change in quality of service is ignored. Price elasticity is much lower during a drought than during normal conditions

    HPV infection and immunochemical detection of cell-cycle markers in verrucous carcinoma of the penis

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    Penile verrucous carcinoma is a rare disease and little is known of its aetiology or pathogenesis. In this study we examined cell-cycle proteins expression and correlation with human papillomavirus infection in a series of 15 pure penile verrucous carcinomas from a single centre. Of 148 penile tumours, 15 (10%) were diagnosed as pure verrucous carcinomas. The expression of the cell-cycle-associated proteins p53, p21, RB, p16INK4A and Ki67 were examined by immunohistochemistry. Human papillomavirus infection was determined by polymerase chain reaction to identify a wide range of virus types. The expression of p16INK4A and Ki67 was significantly lower in verrucous carcinoma than in usual type squamous cell carcinoma, whereas the expression of p53, p21 and RB was not significantly different. p53 showed basal expression in contrast to usual type squamous cell carcinoma. Human papillomavirus infection was present in only 3 out of 13 verrucous carcinomas. Unique low-risk, high-risk and mixed viral infections were observed in each of the three cases. In conclusion, lower levels of p16INK4A and Ki67 expressions differentiate penile verrucous carcinoma from usual type squamous cell carcinoma. The low Ki67 index reflects the slow-growing nature of verrucous tumours. The low level of p16INK4A expression and human papillomavirus detection suggests that penile verrucous carcinoma pathogenesis is unrelated to human papillomavirus infection and the oncogenes and tumour suppressor genes classically altered by virus infection.Peer reviewedFinal Accepted Versio

    A discrete genetic locus confers xyloglucan metabolism in select human gut Bacteroidetes

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    A well-balanced human diet includes a significant intake of non-starch polysaccharides, collectively termed 'dietary fibre', from the cell walls of diverse fruits and vegetables. Owing to the paucity of alimentary enzymes encoded by the human genome, our ability to derive energy from dietary fibre depends on the saccharification and fermentation of complex carbohydrates by the massive microbial community residing in our distal gut. The xyloglucans (XyGs) are a ubiquitous family of highly branched plant cell wall polysaccharides whose mechanism(s) of degradation in the human gut and consequent importance in nutrition have been unclear. Here we demonstrate that a single, complex gene locus in Bacteroides ovatus confers XyG catabolism in this common colonic symbiont. Through targeted gene disruption, biochemical analysis of all predicted glycoside hydrolases and carbohydrate-binding proteins, and three-dimensional structural determination of the vanguard endo-xyloglucanase, we reveal the molecular mechanisms through which XyGs are hydrolysed to component monosaccharides for further metabolism. We also observe that orthologous XyG utilization loci (XyGULs) serve as genetic markers of XyG catabolism in Bacteroidetes, that XyGULs are restricted to a limited number of phylogenetically diverse strains, and that XyGULs are ubiquitous in surveyed human metagenomes. Our findings reveal that the metabolism of even highly abundant components of dietary fibre may be mediated by niche species, which has immediate fundamental and practical implications for gut symbiont population ecology in the context of human diet, nutrition and health
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