Dietary fish oil did not prevent sleep deprived rats from a reduction in adipose tissue adiponectin gene expression

Sleep deprivation in humans has been related to weight gain and consequently, increased risk for insulin resistance. In contrast, there is a significant loss of weight in sleep deprived rats suggesting a state of insulin resistance without obesity interference. Thus, we aimed to assess the effects of a rich fish oil dietetic intervention on glucose tolerance, serum insulin and adiponectin, and adipose tissue gene expression of adiponectin and TNF-α of paradoxically sleep deprived (PSD) rats. The study was performed in thirty day-old male Wistar randomly assigned into two groups: rats fed with control diet (soybean oil as source of fat) and rats fed with a fish oil rich diet. After 45 days of treatment, the animals were submitted to PSD or maintained as home cage control group for 96 h. Body weight and food intake were carefully monitored in all groups. At the end of PSD period, a glucose tolerance test was performed and the total blood and adipose tissues were collected. Serum insulin and adiponectin were analyzed. Adipose tissues were used for RT-PCR to estimate the gene expression of adiponectin and TNF-α. Results showed that although fish oil diet did not exert any effect upon these measurements, PSD induced a reduction in adiponectin gene expression of retroperitoneal adipose tissues, with no change in serum adiponectin concentration or in adiponectin and TNF-α gene expression of epididymal adipose tissue. Thus, the stress induced by sleep deprivation lead to a desbalance of adiponectin gene expression

Prevenção da negligência e violência contra a criança e adolescente : para ensinar e aprender

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An intervention to support adherence to inhaled medication in adults with cystic fibrosis : the ACtiF research programme including RCT

Background People with cystic fibrosis frequently have low levels of adherence to inhaled medications. Objectives The objectives were to develop and evaluate an intervention for adults with cystic fibrosis to improve adherence to their inhaled medication. Design We used agile software methods to develop an online platform. We used mixed methods to develop a behaviour change intervention for delivery by an interventionist. These were integrated to become the CFHealthHub intervention. We undertook a feasibility study consisting of a pilot randomised controlled trial and process evaluation in two cystic fibrosis centres. We evaluated the intervention using an open-label, parallel-group randomised controlled trial with usual care as the control. Participants were randomised in a 1 : 1 ratio to intervention or usual care. Usual care consisted of clinic visits every 3 months. We undertook a process evaluation alongside the randomised controlled trial, including a fidelity study, a qualitative interview study and a mediation analysis. We undertook a health economic analysis using both a within-trial and model-based analysis. Setting The randomised controlled trial took place in 19 UK cystic fibrosis centres. Participants Participants were people aged ≥ 16 years with cystic fibrosis, on the cystic fibrosis registry, not post lung transplant or on the active transplant list, who were able to consent and not using dry-powder inhalers. Intervention People with cystic fibrosis used a nebuliser with electronic monitoring capabilities. This transferred data automatically to a digital platform. People with cystic fibrosis and clinicians could monitor adherence using these data, including through a mobile application (app). CFHealthHub displayed graphs of adherence data as well as educational and problem-solving information. A trained interventionist helped people with cystic fibrosis to address their adherence. Main outcome measures Randomised controlled trial – adjusted incidence rate ratio of pulmonary exacerbations meeting the modified Fuchs criteria over a 12-month follow-up period (primary outcome); change in percentage adherence; and per cent predicted forced expiratory volume in 1 second (key secondary outcomes). Process evaluation – percentage fidelity to intervention delivery, and participant and interventionist perceptions of the intervention. Economic modelling – incremental cost per quality-adjusted life-year gained. Results Randomised controlled trial – 608 participants were randomised to the intervention (n = 305) or usual care (n = 303). To our knowledge, this was the largest randomised controlled trial in cystic fibrosis undertaken in the UK. The adjusted rate of exacerbations per year (primary outcome) was 1.63 in the intervention and 1.77 in the usual-care arm (incidence rate ratio 0.96, 95% confidence interval 0.83 to 1.12; p = 0.638) after adjustment for covariates. The adjusted difference in mean weekly normative adherence was 9.5% (95% confidence interval 8.6% to 10.4%) across 1 year, favouring the intervention. Adjusted mean difference in forced expiratory volume in 1 second (per cent) predicted at 12 months was 1.4% (95% confidence interval –0.2% to 3.0%). No adverse events were related to the intervention. Process evaluation – fidelity of intervention delivery was high, the intervention was acceptable to people with cystic fibrosis, participants engaged with the intervention [287/305 (94%) attended the first intervention visit], expected mechanisms of action were identified and contextual factors varied between randomised controlled trial sites. Qualitative interviews with 22 people with cystic fibrosis and 26 interventionists identified that people with cystic fibrosis welcomed the objective adherence data as proof of actions to self and others, and valued the relationship that they built with the interventionists. Economic modelling – the within-trial analysis suggests that the intervention generated 0.01 additional quality-adjusted life-years at an additional cost of £865.91 per patient, leading to an incremental cost-effectiveness ratio of £71,136 per quality-adjusted life-year gained. This should be interpreted with caution owing to the short time horizon. The health economic model suggests that the intervention is expected to generate 0.17 additional quality-adjusted life-years and cost savings of £1790 over a lifetime (70-year) horizon; hence, the intervention is expected to dominate usual care. Assuming a willingness-to-pay threshold of £20,000 per quality-adjusted life-year gained, the probability that the intervention generates more net benefit than usual care is 0.89. The model results are dependent on assumptions regarding the duration over which costs and effects of the intervention apply, the impact of the intervention on forced expiratory volume in 1 second (per cent) predicted and the relationship between increased adherence and drug-prescribing levels. Limitations Number of exacerbations is a sensitive and valid measure of clinical change used in many trials. However, data collection of this outcome in this context was challenging and could have been subject to bias. It was not possible to measure baseline adherence accurately. It was not possible to quantify the impact of the intervention on the number of packs of medicines prescribed. Conclusions We developed a feasible and acceptable intervention that was delivered to fidelity in the randomised controlled trial. We observed no statistically significant difference in the primary outcome of exacerbation rates over 12 months. We observed an increase in normative adherence levels in a disease where adherence levels are low. The magnitude of the increase in adherence may not have been large enough to affect exacerbations. Future work Given the non-significant difference in the primary outcome, further research is required to explore why an increase in objective normative adherence did not reduce exacerbations and to develop interventions that reduce exacerbations. Trial registration Work package 3.1: Current Controlled Trials ISRCTN13076797. Work packages 3.2 and 3.3: Current Controlled Trials ISRCTN55504164

Oil palm monoculture induces drastic erosion of an Amazonian forest mammal fauna

Oil palm monoculture comprises one of the most financially attractive land-use options in tropical forests, but cropland suitability overlaps the distribution of many highly threatened vertebrate species. We investigated how forest mammals respond to a landscape mosaic, including mature oil palm plantations and primary forest patches in Eastern Amazonia. Using both line-transect censuses (LTC) and camera-trapping (CT), we quantified the general patterns of mammal community structure and attempted to identify both species life-history traits and the environmental and spatial covariates that govern species intolerance to oil palm monoculture. Considering mammal species richness, abundance, and species composition, oil palm plantations were consistently depauperate compared to the adjacent primary forest, but responses differed between functional groups. The degree of forest habitat dependency was a leading trait, determining compositional dissimilarities across habitats. Considering both the LTC and CT data, distance from the forest-plantation interface had a significant effect on mammal assemblages within each habitat type. Approximately 87% of all species detected within oil palm were never farther than 1300 m from the forest edge. Our study clearly reinforces the notion that conventional oil palm plantations are extremely hostile to native tropical forest biodiversity, which does not bode well given prospects for oil palm expansion in both aging and new Amazonian deforestation frontiers

Mesoporous silica nanoparticles with tunable pore size for tailored gold nanoparticles

The aim of this paper was to verify a possible correlation between the pore-size of meso- porous silica nanoparticles (MSNs) and the sizes of gold nanoparticles (AuNPs) obtained by an impreg- nation of gold(III) chloride hydrate solution in the MSNs, followed by a specific thermal treatment. Mesoporous silica nanoparticles with tunable pore diameter were synthesized via a surfactant-assisted method. Tetraethoxysilane as silica precursor, cetyl- trimethylammonium bromide (CTAB) as surfactant and toluene as swelling agent were used. By varying the CTAB–toluene molar ratio, the average dimension of the pores could be tuned from 2.8 to 5.5 nm. Successively, thiol groups were grafted on the surface of the MSNs. Finally, the thermal evolution of the gold salt, followed by ‘‘in situ’’ X-ray powder diffraction (XRPD) and thermogravimetric analysis (TGA), revealed an evident correlation among the degradation of the thiol groups, the pore dimension of the MSNs and the size of the AuNPs. The samples were characterized by means of nitrogen adsorption– desorption, transmission electron microscopy, small- angle X-ray scattering, XRPD ‘‘in situ’’ by synchro- tron radiation, and ‘‘ex situ’’ by conventional tech- niques, diffuse reflectance infrared Fourier transform spectroscopy, and TGA