Low medication adherence in patients with Short Bowel Syndrome dependent on parenteral nutrition

Study design: Cross-sectional. Aim: We aimed to investigate adherence to oral medications in patients with severe Short Bowel Syndrome (SBS). Casuistic and Methods: Ten patients with severe intestinal failure attending a specialized unit in a university hospital were enrolled in this study. All patients received intermittent parenteral nutrition for at least 4 months. The participants (six men and four women) had 56 ± 13 years and body mass index of 18 ± 3 kg/m2. Information related to the use of medications at home was recorded, and adherence behavior was assessed by using the Morisky Medication Adherence Scale. Results: Four patients (40%) had high medication adherence. Among patients with low medication adherence, unintentional behavior was observed in two patients, intentional behavior was observed in one patient, and an association of unintentional with intentional behavior was identified in three patients. Conclusion: Outside the hospital setting, most patients with SBS have low adherence to oral medications. These results suggest the development and implementation of targeted strategies aimed to promote awareness and adherence to medication treatmentModelo do estudo: Transversal. Objetivo do estudo: Avaliar a adesão de pacientes com Síndrome do Intestino Curto ao tratamento medicamentoso por via oral. Casuística e Métodos: O estudo inclui 10 pacientes com Síndrome do Intestino Curto (SIC) acompanhados em unidade especializada de um hospital universitário. Todos os pacientes recebiam nutrição parenteral por no mínimo quatro meses. A casuística consistia em seis homens e quatro mulheres, com idade de 56 ± 13 anos e Índice de Massa Corporal de 18 ± 3kg/m2. Foram registradas informações sobre o uso de medicamentos no domicílio. A adesão ao tratamento medicamentoso foi avaliada pelo teste de Morisky e foi identificada a natureza do comportamento em relação à não adesão. Resultados Apenas 40% dos pacientes foram classificados como “mais aderentes”. Dentre os “menos aderentes”, a baixa adesão por associação do comportamento intencional e não intencional foi observada em três casos; dois pacientes apresentavam apenas o comportamento intencional e o comportamento não intencional foi documentado em um paciente. Conclusões: A maioria dos pacientes tem baixa adesão ao tratamento medicamentoso por via oral durante o período em que eles permanecem em seus domicílios. Tais resultados sugerem o desenvolvimento e a implementação de estratégias que visem à percepção da relevância do uso correto dos medicamentos e a promoção da adesão ao tratamento medicamentos

Time to integrate global climate change and biodiversity science‐policy agendas

Funder: Research EnglandFunder: Bertarelli FoundationAbstract: There is an increasing recognition that, although the climate change and biodiversity crises are fundamentally connected, they have been primarily addressed independently and a more integrated global approach is essential to tackle these two global challenges. Nature‐based Solutions (NbS) are hailed as a pathway for promoting synergies between the climate change and biodiversity agendas. There are, however, uncertainties and difficulties associated with the implementation of NbS, while the evidence regarding their benefits for biodiversity remains limited. We identify five key research areas where incomplete or poor information hinders the development of integrated biodiversity and climate solutions. These relate to refining our understanding of how climate change mitigation and adaptation approaches benefit biodiversity conservation; enhancing our ability to track and predict ecosystems on the move and/or facing collapse; improving our capacity to predict the impacts of climate change on the effectiveness of NbS; developing solutions that match the temporal, spatial and functional scale of the challenges; and developing a comprehensive and practical framework for assessing, and mitigating against, the risks posed by the implementation of NbS. Policy implications. The Conference of the Parties (COP) for the United Nations Framework Convention on Climate Change (COP26) and the Convention on Biological Diversity (COP15) present a clear policy window for developing coherent policy frameworks that align targets across the nexus of biodiversity and climate change. This window should (a) address the substantial and chronic underfunding of global biodiversity conservation, (b) remove financial incentives that negatively impact biodiversity and/or climate change, (c) develop higher levels of integration between the biodiversity and climate change agendas, (d) agree on a monitoring framework that enables the standardised quantification and comparison of biodiversity gains associated with NbS across ecosystems and over time and (e) rethink environmental legislation to better support biodiversity conservation in times of rapid climatic change

Soroprevalência de Rickettsias do grupo da Febre Maculosa em cães residentes em Unidade de Conservação do Rio de Janeiro / Soroprevalence of Rickettsias from the Maculosa Fever group in dogs living in the Rio de Janeiro Conservation Unit

O monitoramento de doenças infecciosas, parasitárias e zoonóticas é fundamental para a saúde coletiva e até mesmo ecossistêmica, principalmente em Unidades de Conservação, como o Parque Estadual da Serra da Tiririca-RJ (PESET). Rickettsias do Grupo da Febre Maculosa estão associadas a artrópodes hematófagos e podem causar uma doença potencialmente letal em humanos. Nesse contexto, ações de monitoramento em prol do diagnóstico de áreas de risco são de extrema importância. O PESET está localizado nos Municípios de Niterói e Maricá e abriga rica diversidade biológica, além de remanescentes de comunidades humanas de origens diversas. A maioria dos moradores possui animais domésticos, principalmente cães, o que permite uma interação entre eles, a fauna e o homem, contribuindo para a transmissão de patógenos de importância na saúde pública. O objetivo desta pesquisa foi realizar o inquérito sorológico de Rickettsias do Grupo de Febre Maculosa utilizando a reação de imunofluorescência indireta, a fim de contribuir como ferramenta de monitoramento da Febre Maculosa e auxiliar em futuras medidas de prevenção e controle. Como resultado, encontramos em 146 cães uma prevalência de 23% de reatividade para R. rickettsii e 47% de reatividade para R. parkeri, com título máximo de 1: 512 para ambos os antígenos. O presente trabalho demonstrou que tanto R. rickettsii quanto R. parkeri circulam na área estudada, alertando para a importância dos caninos como sentinelas de ambos os antígenos e servindo como alerta para futuros casos humanos

Risk factors for infection, predictors of severe disease, and antibody response to COVID-19 in patients with inflammatory rheumatic diseases in Portugal: a multicenter, nationwide study

Copyright © 2022 Cruz-Machado, Barreira, Bandeira, Veldhoen, Gomes, Serrano, Duarte, Rato, Miguel Fernandes, Garcia, Pinheiro, Bernardes, Madeira, Miguel, Torres, Bento Silva, Pestana, Almeida, Mazeda, Cunha Santos, Pinto, Sousa, Parente, Sequeira, Santos, Fonseca and Romão. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.Objective: To identify risk factors for SARS-CoV-2 infection and for severe/critical COVID-19, and to assess the humoral response after COVID-19 in these patients. Methods: Nationwide study of adult patients with inflammatory RMDs prospectively followed in the Rheumatic Diseases Portuguese Register-Reuma.pt-during the first 6 months of the pandemic. We compared patients with COVID-19 with those who did not develop the disease and patients with mild/moderate disease with those exhibiting severe/critical COVID-19. IgG antibodies against SARS-CoV-2 were measured ≥3 months after infection and results were compared with matched controls. Results: 162 cases of COVID-19 were registered in a total of 6,363 appointments. Patients treated with TNF inhibitors (TNFi; OR = 0.160, 95% CI 0.099-0.260, P < 0.001) and tocilizumab (OR 0.147, 95% CI 0.053-0.408, P < 0.001) had reduced odds of infection. Further, TNFi tended to be protective of severe and critical disease. Older age, major comorbidities, and rituximab were associated with an increased risk of infection and worse prognosis. Most patients with inflammatory RMDs (86.2%) developed a robust antibody response. Seroconversion was associated with symptomatic disease (OR 13.46, 95% CI 2.21-81.85, P = 0.005) and tended to be blunted by TNFi (OR 0.17, 95% CI 0.03-1.05; P = 0.057). Conclusions: TNFi and tocilizumab reduced the risk of infection by SARS-CoV-2. Treatment with TNFi also tended to reduce rates of severe disease and seroconversion. Older age, general comorbidities and rituximab were associated with increased risk for infection and worse prognosis, in line with previous reports. Most patients with RMDs developed a proper antibody response after COVID-19, particularly if they had symptomatic disease.We acknowledge the generous sharing of the expression constructs by Dr. Florian Krammer, Icahn School of Medicine at Mount Sinai, New York, USA [Development of SARS-CoV-2 reagents was partially supported by the NIAID Centers of Excellence for Influenza Research and Surveillance (CEIRS) contract HHSN272201400008C] and the protein production by Drs. Paula Alves and Rute Castro at Instituto de Biologia Experimental e Tecnológica (iBET) Oeiras, Portugal as part of the Serology COVID consortium.info:eu-repo/semantics/publishedVersio

Exercise training prevents oxidative stress and ubiquitin-proteasome system overactivity and reverse skeletal muscle atrophy in heart failure

Background: Heart failure (HF) is known to lead to skeletal muscle atrophy and dysfunction. However, intracellular mechanisms underlying HF-induced myopathy are not fully understood. We hypothesized that HF would increase oxidative stress and ubiquitin-proteasome system (UPS) activation in skeletal muscle of sympathetic hyperactivity mouse model. We also tested the hypothesis that aerobic exercise training (AET) would reestablish UPS activation in mice and human HF. Methods/Principal Findings: Time-course evaluation of plantaris muscle cross-sectional area, lipid hydroperoxidation, protein carbonylation and chymotrypsin-like proteasome activity was performed in a mouse model of sympathetic hyperactivity-induced HF. At the 7th month of age, HF mice displayed skeletal muscle atrophy, increased oxidative stress and UPS overactivation. Moderate-intensity AET restored lipid hydroperoxides and carbonylated protein levels paralleled by reduced E3 ligases mRNA levels, and reestablished chymotrypsin-like proteasome activity and plantaris trophicity. In human HF (patients randomized to sedentary or moderate-intensity AET protocol), skeletal muscle chymotrypsin-like proteasome activity was also increased and AET restored it to healthy control subjects' levels. Conclusions: Collectively, our data provide evidence that AET effectively counteracts redox imbalance and UPS overactivation, preventing skeletal myopathy and exercise intolerance in sympathetic hyperactivity-induced HF in mice. Of particular interest, AET attenuates skeletal muscle proteasome activity paralleled by improved aerobic capacity in HF patients, which is not achieved by drug treatment itself. Altogether these findings strengthen the clinical relevance of AET in the treatment of HF.Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) [2006/61523-7, 2006/58460-4]Conselho Nacional de Pesquisa e Desenvolvimento (CNPq) [473251/2009-4, 301519/2008-0, 301867/2010-0]Conselho Nacional de Pesquisa e Desenvolvimento (CNPq

The Fourteenth Data Release of the Sloan Digital Sky Survey: First Spectroscopic Data from the extended Baryon Oscillation Spectroscopic Survey and from the second phase of the Apache Point Observatory Galactic Evolution Experiment

The fourth generation of the Sloan Digital Sky Survey (SDSS-IV) has been in operation since July 2014. This paper describes the second data release from this phase, and the fourteenth from SDSS overall (making this, Data Release Fourteen or DR14). This release makes public data taken by SDSS-IV in its first two years of operation (July 2014-2016). Like all previous SDSS releases, DR14 is cumulative, including the most recent reductions and calibrations of all data taken by SDSS since the first phase began operations in 2000. New in DR14 is the first public release of data from the extended Baryon Oscillation Spectroscopic Survey (eBOSS); the first data from the second phase of the Apache Point Observatory (APO) Galactic Evolution Experiment (APOGEE-2), including stellar parameter estimates from an innovative data driven machine learning algorithm known as "The Cannon"; and almost twice as many data cubes from the Mapping Nearby Galaxies at APO (MaNGA) survey as were in the previous release (N = 2812 in total). This paper describes the location and format of the publicly available data from SDSS-IV surveys. We provide references to the important technical papers describing how these data have been taken (both targeting and observation details) and processed for scientific use. The SDSS website (www.sdss.org) has been updated for this release, and provides links to data downloads, as well as tutorials and examples of data use. SDSS-IV is planning to continue to collect astronomical data until 2020, and will be followed by SDSS-V.Comment: SDSS-IV collaboration alphabetical author data release paper. DR14 happened on 31st July 2017. 19 pages, 5 figures. Accepted by ApJS on 28th Nov 2017 (this is the "post-print" and "post-proofs" version; minor corrections only from v1, and most of errors found in proofs corrected

The Eleventh and Twelfth Data Releases of the Sloan Digital Sky Survey: Final Data from SDSS-III

The third generation of the Sloan Digital Sky Survey (SDSS-III) took data from 2008 to 2014 using the original SDSS wide-field imager, the original and an upgraded multi-object fiber-fed optical spectrograph, a new near-infrared high-resolution spectrograph, and a novel optical interferometer. All of the data from SDSS-III are now made public. In particular, this paper describes Data Release 11 (DR11) including all data acquired through 2013 July, and Data Release 12 (DR12) adding data acquired through 2014 July (including all data included in previous data releases), marking the end of SDSS-III observing. Relative to our previous public release (DR10), DR12 adds one million new spectra of galaxies and quasars from the Baryon Oscillation Spectroscopic Survey (BOSS) over an additional 3000 deg2 of sky, more than triples the number of H-band spectra of stars as part of the Apache Point Observatory (APO) Galactic Evolution Experiment (APOGEE), and includes repeated accurate radial velocity measurements of 5500 stars from the Multi-object APO Radial Velocity Exoplanet Large-area Survey (MARVELS). The APOGEE outputs now include the measured abundances of 15 different elements for each star. In total, SDSS-III added 5200 deg2 of ugriz imaging; 155,520 spectra of 138,099 stars as part of the Sloan Exploration of Galactic Understanding and Evolution 2 (SEGUE-2) survey; 2,497,484 BOSS spectra of 1,372,737 galaxies, 294,512 quasars, and 247,216 stars over 9376 deg2; 618,080 APOGEE spectra of 156,593 stars; and 197,040 MARVELS spectra of 5513 stars. Since its first light in 1998, SDSS has imaged over 1/3 of the Celestial sphere in five bands and obtained over five million astronomical spectra. \ua9 2015. The American Astronomical Society