Inducible Nitric Oxide Synthase Provides Protection Against Injury-Induced Thrombosis in Female Mice

Nitric oxide (NO) is an important vasoactive molecule produced by three NO synthase (NOS) enzymes: neuronal (nNOS), inducible (iNOS) and endothelial NOS (eNOS). While eNOS contributes to blood vessel dilation that is generally thought to protect against the development of hypertension, iNOS has been primarily implicated as a disease-promoting isoform leading to protein-bound 3-nitrotyrosine formation in aortic lesions and select organs during atherogenesis. Despite this, iNOS may also play a physiological role, via the modulation of cyclooxygenase and thromboregulatory eicosanoid production. Herein, we examined the role of iNOS in a murine model of thrombosis. Blood flow was measured in carotid arteries of male and female wild-type (WT) and iNOS-deficient mice following ferric chloride-induced thrombosis. Female WT mice were less susceptible to thrombotic occlusion than male counterparts, but this protection was lost upon iNOS deletion. In contrast, male mice (with and without iNOS deletion) were equally susceptible to thrombosis. The protective effect that iNOS affords female WT mice was not associated with a change in the balance of thromboxane A2 (TxA2) and antithrombotic prostacyclin (PGI2). Our findings, however, suggest that iNOS generates a protective source of NO in female WT mice that attenuates the effects of vascular injury. Thus, although iNOS is likely detrimental during atherogenesis, physiological iNOS levels may play a protective role in preventing thrombotic occlusion, a phenomenon that may be enhanced in female mice

Role of antiseptics in the prevention and treatment of infections in nursing homes

Inadequate infection control, wound care, and oral hygiene protocols in nursing homes provide challenges to residents’ quality of life. Based on the outcomes from a focus group meeting and a literature search, this narrative review evaluates the current and potential roles of antiseptics within nursing home infection management procedures. We examine contemporary strategies and concerns within the management of meticillin-resistant Staphylococcus aureus (MRSA; including decolonization regimes), chronic wound care, and oral hygiene, and review the available data for the use of antiseptics, with a focus on povidone-iodine. Compared with chlorhexidine, polyhexanide, and silver, povidone-iodine has a broader spectrum of antimicrobial activity, with rapid and potent activity against MRSA and other microbes found in chronic wounds, including biofilms. As no reports of bacterial resistance or cross-resistance following exposure to povidone-iodine exist, it may be preferable for MRSA decolonization compared with mupirocin and chlorhexidine, which can cause resistant MRSA strains. Povidone-iodine oral products have greater efficacy against oral pathogens compared with other antiseptics such as chlorhexidine mouthwash, highlighting the clinical benefit of povidone-iodine in oral care. Additionally, povidone-iodine-based products, including mouthwash, have demonstrated rapid in vitro virucidal activity against SARS-CoV-2 and may help reduce its transmission if incorporated into nursing home coronavirus 2019 control protocols. Importantly, povidone-iodine activity is not adversely affected by organic material, such as that found in chronic wounds and the oral cavity. Povidone-iodine is a promising antiseptic agent for the management of infections in the nursing home setting, including MRSA decolonization procedures, chronic wound management, and oral care.N/

Scaling up sustainability in commodity agriculture: Transferability of governance mechanisms across the coffee and cattle sectors in Brazil

A number of governance mechanisms address socio-environmental challenges associated with commodity agriculture in tropical forested countries. Governance mechanisms that prove effective in one agricultural sector are often applied to other sectors as well. For example, voluntary certification programs have been adopted by producers of commodities as diverse as beef, coffee, palm oil, and soy. However, there are substantial differences in the extent to which governance mechanisms scale up and achieve impact in different sectors. This paper analyzes how the potential for scaling up a particular governance mechanism is influenced by environmental, market, and social geographies that differ between sectors. Through stakeholder interviews, farm-level surveys, and a literature review, we examine two types of voluntary governance mechanisms (third-party certification, and sustainable intensification programs) in the coffee and cattle sectors in Brazil, to understand why the two governance mechanisms have scaled differently between these two sectors. We find that third-party certification programs have scaled up relatively well in Brazil\u27s coffee sector, more so than its cattle sector, in part owing to differences in sustainability priorities, market orientations, supply chain traceability, and social networks between the two sectors. We also find that pilot sustainable intensification programs in the cattle sector have had more success than certification in engaging farmers, in part because they involve less investment from participating farmers. We conclude that the distribution and quality of environmental resources, markets, knowledge, actors, and networks can play an important role in the ability of a governance mechanism to effectively take root

CWRML: representing crop wild relative conservation and use data in XML

Background Crop wild relatives are wild species that are closely related to crops. They are valuable as potential gene donors for crop improvement and may help to ensure food security for the future. However, they are becoming increasingly threatened in the wild and are inadequately conserved, both in situ and ex situ. Information about the conservation status and utilisation potential of crop wild relatives is diverse and dispersed, and no single agreed standard exists for representing such information; yet, this information is vital to ensure these species are effectively conserved and utilised. The European Community-funded project, European Crop Wild Relative Diversity Assessment and Conservation Forum, determined the minimum information requirements for the conservation and utilisation of crop wild relatives and created the Crop Wild Relative Information System, incorporating an eXtensible Markup Language (XML) schema to aid data sharing and exchange. Results Crop Wild Relative Markup Language (CWRML) was developed to represent the data necessary for crop wild relative conservation and ensure that they can be effectively utilised for crop improvement. The schema partitions data into taxon-, site-, and population-specific elements, to allow for integration with other more general conservation biology schemata which may emerge as accepted standards in the future. These elements are composed of sub-elements, which are structured in order to facilitate the use of the schema in a variety of crop wild relative conservation and use contexts. Pre-existing standards for data representation in conservation biology were reviewed and incorporated into the schema as restrictions on element data contents, where appropriate. Conclusion CWRML provides a flexible data communication format for representing in situ and ex situ conservation status of individual taxa as well as their utilisation potential. The development of the schema highlights a number of instances where additional standards-development may be valuable, particularly with regard to the representation of population-specific data and utilisation potential. As crop wild relatives are intrinsically no different to other wild plant species there is potential for the inclusion of CWRML data elements in the emerging standards for representation of biodiversity data

High-resolution polarimetry of Parsamian 21: revealing the structure of an edge-on FU Ori disc

We present the first high spatial resolution near-infrared direct and polarimetric observations of Parsamian 21, obtained with the VLT/NACO instrument. We complemented these measurements with archival infrared observations, such as HST/WFPC2 imaging, HST/NICMOS polarimetry, Spitzer IRAC and MIPS photometry, Spitzer IRS spectroscopy as well as ISO photometry. Our main conclusions are the following: (1) we argue that Parsamian 21 is probably an FU Orionis-type object; (2) Parsamian 21 is not associated with any rich cluster of young stars; (3) our measurements reveal a circumstellar envelope, a polar cavity and an edge-on disc; the disc seems to be geometrically flat and extends from approximately 48 to 360 AU from the star; (4) the SED can be reproduced with a simple model of a circumstellar disc and an envelope; (5) within the framework of an evolutionary sequence of FUors proposed by Green et al. (2006) and Quanz et al. (2007), Parsamian 21 can be classified as an intermediate-aged object.Comment: Accepted for publication in the MNRAS. 16 pages, 18 figures and 5 table

Treatment of hypertension in rural Cambodia: results of a 6-year programme

This study was aimed to describe the outcomes of a hypertension treatment programme in two outpatient clinics in Cambodia. We determined proportions of patients who met the optimal targets for blood pressure (BP) control and assessed the evolution of mean systolic and diastolic BP (SBP/DBP) over time. Multivariate analyses were used to identify predictors of BP decrease and risk factors for LTFU. A total of 2858 patients were enrolled between March 2002 and June 2008 of whom 69.2% were female, 30.5% were aged >/=64years and 32.6% were diabetic. The median follow-up time was 600 days. By the end of 2008, 1642 (57.4%) were alive-in-care, 8 (0.3%) had died and 1208 (42.3%) were lost to follow-up. On admission, mean SBP and DBP were 162 and 94 mm Hg, respectively. Among the patients treated, a significant SBP reduction of 26.8 mm Hg (95% CI: 28.4-25.3) was observed at 6 months. Overall, 36.5% of patients reached the BP targets at 24 months. The number of young adults, non-overweight patients and non-diabetics reaching the BP targets was more. Older age (>64 years), uncontrolled DBP (>/=90 mm Hg) on last consultation and coming late for the last consultation were associated with LTFU, whereas non-diabetic patients were 1.5 times more likely to default than diabetics (95% CI: 1.3-1.7). Although the definite magnitude of the BP decrease due to antihypertension medication over time cannot be assessed definitely without a control group, our results suggest that BP reduction can be obtained with essential hypertension treatment in a large-scale programme in a resource-limited setting

Geriatric pharmacotherapy : optimisation through integrated approach in the hospital setting

Since older patients are more vulnerable to adverse drug-related events, there is a need to ensure appropriate prescribing in these patients in order to prevent misuse, overuse and underuse of drugs. Different tools and strategies have been developed to reduce inappropriate prescribing; the available measures can be divided into medication assessment tools, and specific interventions to reduce inappropriate prescribing. Implicit criteria of inappropriate prescribing focus on appropriate dosing, search for drug-drug interactions, and increase adherence. Explicit criteria are consensus-based standards focusing on drugs and diseases and include lists of drugs to avoid in general or lists combining drugs with clinical data. These criteria take into consideration differences between patients, and stand for a medication review, by using a systematic approach. Different types of interventions exist in order to reduce inappropriate prescribing in older patients, such as: educational interventions, computerized decision support systems, pharmacist-based interventions, and geriatric assessment. The effects of these interventions have been studied, sometimes in a multifaceted approach combining different techniques, and all types seem to have positive effects on appropriateness of prescribing. Interdisciplinary teamwork within the integrative pharmaceutical care is important for improving of outcomes and safety of drug therapy. The pharmaceutical care process consists offour steps, which are cyclic for an individual patient. These steps are pharmaceutical anamnesis, medication review, design and follow-up of a pharmaceutical care plan. A standardized approach is necessary for the adequate detection and evaluation of drug-related problems. Furthermore, it is clear that drug therapy should be reviewed in-depth, by having full access to medical records, laboratory values and nursing notes. Although clinical pharmacists perform the pharmaceutical care process to manage the patient’s drug therapy in every day clinical practice, the physician takes the ultimate responsibility for the care of the patient in close collaboration with nurses

An international comparative study of blood pressure in populations of European vs. African descent

Background: The consistent finding of higher prevalence of hypertension in US blacks compared to whites has led to speculation that African-origin populations are particularly susceptible to this condition. Large surveys now provide new information on this issue. Methods: Using a standardized analysis strategy we examined prevalence estimates for 8 white and 3 black populations (N = 85,000 participants). Results: The range in hypertension prevalence was from 27 to 55% for whites and 14 to 44% for blacks. Conclusions: These data demonstrate that not only is there a wide variation in hypertension prevalence among both racial groups, the rates among blacks are not unusually high when viewed internationally. These data suggest that the impact of environmental factors among both populations may have been under-appreciated