Identifying malnutrition in emergency general surgery:systematic review

Background: Emergency general surgery practice is high risk. Surgery is a key part of treatment, with resultant catabolic stress and frequent need for nutritional support. The aim of this study was to examine the current methods of defining and determining malnutrition in emergency general surgery. This included examining the use of nutrition screening and assessment tools and other measures of malnutrition.Methods: MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, trial registries, and relevant journals published between January 2000 and January 2022 were searched for studies of adult patients with any emergency general surgery diagnosis, managed conservatively or operatively, with an assessment of nutritional status. Mixed populations were included if more than 50 per cent of patients were emergency general surgery patients or emergency general surgery results could be separately extracted. Studies in which patients had received nutritional support were excluded. The protocol was registered with PROSPERO, the international prospective register of systematic reviews (CRD42021285897).Results: From 6700 studies screened, 324 full texts were retrieved and 31 were included in the analysis. A definition of malnutrition was provided in 23 studies (75 per cent), with nutritional status being determined by a variety of methods. A total of seven nutrition screening tools and a total of nine ‘assessment’ tools were reported. To define malnutrition, the most commonly used primary or secondary marker of nutritional status was BMI, followed by albumin level.Conclusion: Wide variation exists in approaches to identify malnutrition risk in emergency general surgery patients, using a range of tools and nutrition markers. Future studies should seek to standardize nutrition screening and assessment in the emergency general surgery setting as two discrete processes. This will permit better understanding of malnutrition risk in surgical patients

The Active Traveling Wave in the Cochlea

A sound stimulus entering the inner ear excites a deformation of the basilar membrane which travels along the cochlea towards the apex. It is well established that this wave-like disturbance is amplified by an active system. Recently, it has been proposed that the active system consists of a set of self-tuned critical oscillators which automatically operate at an oscillatory instability. Here, we show how the concepts of a traveling wave and of self-tuned critical oscillators can be combined to describe the nonlinear wave in the cochlea.Comment: 5 pages, 2 figure

A closed expression for the UV-divergent parts of one-loop tensor integrals in dimensional regularization

Starting from the general definition of a one-loop tensor N-point function, we use its Feynman parametrization to calculate the UV-divergent part of an arbitrary tensor coefficient in the framework of dimensional regularization. In contrast to existing recursion schemes, we are able to present a general analytic result in closed form that enables direct determination of the UV-divergent part of any one-loop tensor N-point coefficient independent from UV-divergent parts of other one-loop tensor N-point coefficients. Simplified formulas and explicit expressions are presented for A-, B-, C-, D-, E-, and F-functions.Comment: 19 pages (single column), the result of previous versions is further evaluated leading to a closed analytic expression for the UV-divergent part of an arbitrary one-loop tensor coefficient, title is modified accordingly, a sign error in the appendix (C_{00000000}) has been corrected, a mathematica notebook containing an implementation of the newly derived formula is attache

A pilot study exploring the experiences of mental health among internal migrants in Nigeria

Purpose: This article identified and explored factors that impact on the mental health of internal migrants in Nigeria. Design: A pilot qualitative phenomenological study with four participants from the Federal Capital Territory and Lagos states in Nigeria. Semi-structured interviews were undertaken using the application known as Zoom© from August to September 2019. Interviews were analysed using the six steps of thematic analyse described by Braun and Clarke (2006). Findings: Five themes emerged from this study; ‘purpose of migration’, ‘experience of migration’, ‘coping strategies’, ‘knowledge of mental health’, and ‘impact of internal migration on mental health’. In summary, the participants described the reasons or migrating as work, marriage, and wanting a better life. They described having accommodation issues, difficulties finding a job after migration and also experienced challenges of building new friendships. Participants also explained that religion and perseverance helped them cope after relocating. Practical implications: The pilot study concludes that the stress of internal migration combined with socio-economic challenges and lack of social support can result in a lack of ability to settle in a new culture (ethnic group) which may likely result in poor mental health. Originality: This article contributes to existing knowledge of mental health in Nigeria, a sensitive topic that is rarely discussed in the country, by studying an under-researched group (internal migrants)

Global assessment of nitrogen deposition effects on terrestrial plant diversity : a synthesis

Atmospheric nitrogen (N) deposition is it recognized threat to plant diversity ill temperate and northern parts of Europe and North America. This paper assesses evidence from field experiments for N deposition effects and thresholds for terrestrial plant diversity protection across a latitudinal range of main categories of ecosystems. from arctic and boreal systems to tropical forests. Current thinking on the mechanisms of N deposition effects on plant diversity, the global distribution of G200 ecoregions, and current and future (2030) estimates of atmospheric N-deposition rates are then used to identify the risks to plant diversity in all major ecosystem types now and in the future. This synthesis paper clearly shows that N accumulation is the main driver of changes to species composition across the whole range of different ecosystem types by driving the competitive interactions that lead to composition change and/or making conditions unfavorable for some species. Other effects such its direct toxicity of nitrogen gases and aerosols long-term negative effects of increased ammonium and ammonia availability, soil-mediated effects of acidification, and secondary stress and disturbance are more ecosystem, and site-specific and often play a supporting role. N deposition effects in mediterranean ecosystems have now been identified, leading to a first estimate of an effect threshold. Importantly, ecosystems thought of as not N limited, such as tropical and subtropical systems, may be more vulnerable in the regeneration phase. in situations where heterogeneity in N availability is reduced by atmospheric N deposition, on sandy soils, or in montane areas. Critical loads are effect thresholds for N deposition. and the critical load concept has helped European governments make progress toward reducing N loads on sensitive ecosystems. More needs to be done in Europe and North America. especially for the more sensitive ecosystem types. including several ecosystems of high conservation importance. The results of this assessment Show that the Vulnerable regions outside Europe and North America which have not received enough attention are ecoregions in eastern and Southern Asia (China, India), an important part of the mediterranean ecoregion (California, southern Europe). and in the coming decades several subtropical and tropical parts of Latin America and Africa. Reductions in plant diversity by increased atmospheric N deposition may be more widespread than first thought, and more targeted Studies are required in low background areas, especially in the G200 ecoregions

Maternal Metformin Intervention during Obese Glucose-Intolerant Pregnancy Affects Adiposity in Young Adult Mouse Offspring in a Sex-Specific Manner.

BackgroundMetformin is commonly used to treat gestational diabetes mellitus. This study investigated the effect of maternal metformin intervention during obese glucose-intolerant pregnancy on the gonadal white adipose tissue (WAT) of 8-week-old male and female mouse offspring.MethodsC57BL/6J female mice were provided with a control (Con) or obesogenic diet (Ob) to induce pre-conception obesity. Half the obese dams were treated orally with 300 mg/kg/d of metformin (Ob-Met) during pregnancy. Gonadal WAT depots from 8-week-old offspring were investigated for adipocyte size, macrophage infiltration and mRNA expression of pro-inflammatory genes using RT-PCR.ResultsGestational metformin attenuated the adiposity in obese dams and increased the gestation length without correcting the offspring in utero growth restriction and catch-up growth caused by maternal obesity. Despite similar body weight, the Ob and Ob-Met offspring of both sexes showed adipocyte hypertrophy in young adulthood. Male Ob-Met offspring had increased WAT depot weight (p p p F4/80 (p ConclusionsMaternal metformin intervention during obese pregnancy causes excessive adiposity, adipocyte hyperplasia and WAT inflammation in male offspring, highlighting sex-specific effects of prenatal metformin exposure on offspring WAT

Continuous non-perturbative regularization of QED

We regularize in a continuous manner the path integral of QED by construction of a non-local version of its action by means of a regularized form of Dirac's $\delta$ functions. Since the action and the measure are both invariant under the gauge group, this regularization scheme is intrinsically non-perturbative. Despite the fact that the non-local action converges formally to the local one as the cutoff goes to infinity, the regularized theory keeps trace of the non-locality through the appearance of a quadratic divergence in the transverse part of the polarization operator. This term which is uniquely defined by the choice of the cutoff functions can be removed by a redefinition of the regularized action. We notice that as for chiral fermions on the lattice, there is an obstruction to construct a continuous and non ambiguous regularization in four dimensions. With the help of the regularized equations of motion, we calculate the one particle irreducible functions which are known to be divergent by naive power counting at the one loop order.Comment: 23 pages, LaTeX, 5 Encapsulated Postscript figures. Improved and revised version, to appear in Phys. Rev.

Craniux: A LabVIEW-Based Modular Software Framework for Brain-Machine Interface Research

This paper presents “Craniux,” an open-access, open-source software framework for brain-machine interface (BMI) research. Developed in LabVIEW, a high-level graphical programming environment, Craniux offers both out-of-the-box functionality and a modular BMI software framework that is easily extendable. Specifically, it allows researchers to take advantage of multiple features inherent to the LabVIEW environment for on-the-fly data visualization, parallel processing, multithreading, and data saving. This paper introduces the basic features and system architecture of Craniux and describes the validation of the system under real-time BMI operation using simulated and real electrocorticographic (ECoG) signals. Our results indicate that Craniux is able to operate consistently in real time, enabling a seamless work flow to achieve brain control of cursor movement. The Craniux software framework is made available to the scientific research community to provide a LabVIEW-based BMI software platform for future BMI research and development

Suppression of erythropoiesis by dietary nitrate

In mammals, hypoxia-triggered erythropoietin release increases red blood cell mass to meet tissue oxygen demands. Using male Wistar rats, we unmask a previously unrecognized regulatory pathway of erythropoiesis involving suppressor control by the NO metabolite and ubiquitous dietary component nitrate. We find that circulating hemoglobin levels are modulated by nitrate at concentrations achievable by dietary intervention under normoxic and hypoxic conditions; a moderate dose of nitrate administered via the drinking water (7 mg NaNO3/kg body weight/d) lowered hemoglobin concentration and hematocrit after 6 d compared with nonsupplemented/NaCl-supplemented controls. The underlying mechanism is suppression of hepatic erythropoietin expression associated with the downregulation of tissue hypoxia markers, suggesting increased pO2. At higher nitrate doses, however, a partial reversal of this effect occurred; this was accompanied by increased renal erythropoietin expression and stabilization of hypoxia-inducible factors, likely brought about by the relative anemia. Thus, hepatic and renal hypoxia-sensing pathways act in concert to modulate hemoglobin in response to nitrate, converging at an optimal minimal hemoglobin concentration appropriate to the environmental/physiologic situation. Suppression of hepatic erythropoietin expression by nitrate may thus act to decrease blood viscosity while matching oxygen supply to demand, whereas renal oxygen sensing could act as a brake, averting a potentially detrimental fall in hematocrit.—Ashmore, T., Fernandez, B. O., Evans, C. E., Huang, Y., Branco-Price, C., Griffin, J. L., Johnson, R. S., Feelisch, M., and Murray, A. J. Suppression of erythropoiesis by dietary nitrate