Preoperative systemic inflammation predicts postoperative infectious complications in patients undergoing curative resection for colorectal cancer

The presence of systemic inflammation before surgery, as evidenced by the glasgow prognostic score (mGPS), predicts poor long-term survival in colorectal cancer. The aim was to examine the relationship between the preoperative mGPS and the development of postoperative complications in patients undergoing potentially curative resection for colorectal cancer. Patients (n=455) who underwent potentially curative resections between 2003 and 2007 were assessed consecutively, and details were recorded in a database. The majority of patients presented for elective surgery (85%) were over the age of 65 years (70%), were male (58%), were deprived (53%), and had TNM stage I/II disease (61%), had preoperative haemoglobin (56%), white cell count (87%) and mGPS 0 (58%) in the normal range. After surgery, 86 (19%) patients developed a postoperative complication; 70 (81%) of which were infectious complications. On multivariate analysis, peritoneal soiling (P<0.01), elevated preoperative white cell count (P<0.05) and mGPS (P<0.01) were independently associated with increased risk of developing a postoperative infection. In elective patients, only the mGPS (OR=1.75, 95% CI=1.17-2.63, P=0.007) was significantly associated with increased risk of developing a postoperative infection. Preoperative elevated mGPS predicts increased postoperative infectious complications in patients undergoing potentially curative resection for colorectal cancer

Behavioral Inhibition as a Risk Factor for the Development of Childhood Anxiety Disorders: A Longitudinal Study

This longitudinal study examined the additive and interactive effects of behavioral inhibition and a wide range of other vulnerability factors in the development of anxiety problems in youths. A sample of 261 children, aged 5 to 8 years, 124 behaviorally inhibited and 137 control children, were followed during a 3-year period. Assessments took place on three occasions to measure children’s level of behavioral inhibition, anxiety disorder symptoms, other psychopathological symptoms, and a number of other vulnerability factors such as insecure attachment, negative parenting styles, adverse life events, and parental anxiety. Results obtained with Structural Equation Modeling indicated that behavioral inhibition primarily acted as a specific risk factor for the development of social anxiety symptoms. Furthermore, the longitudinal model showed additive as well as interactive effects for various vulnerability factors on the development of anxiety symptoms. That is, main effects of anxious rearing and parental trait anxiety were found, whereas behavioral inhibition and attachment had an interactive effect on anxiety symptomatology. Moreover, behavioral inhibition itself was also influenced by some of the vulnerability factors. These results provide support for dynamic, multifactorial models for the etiology of child anxiety problems

The role of usability engineering in the development of an intelligent decision support system

This paper presents an overview of the usability engineering process for the development of a personalised clinical decision support system for the management of type 1 diabetes. The tool uses artificial intelligence (AI) techniques to provide insulin bolus dose advice and carbohydrate recommendations that adapt to the individual. We describe the role of human factors and user-centred design in the creation of medical systems that must adhere to international standards. We focus specifically on the formative evaluation stage of this process. The preliminary analysis of data shows promising results

Year patterns of climate impact on wheat yields

Rainfall, temperature, and solar radiation are important climate factors, which determine crop growth, development and yield from instantaneous to decadal scales. We propose to identify year patterns of climate impact on yield on the basis of rain and non-rain weather. There are inter-related impacts of climatic factors on crop production within a specific pattern. Historical wheat yield data in Queensland during 1889-2004 were used. The influence of meteorological conditions on wheat yields was derived from statistical yield data which were detrended by 9-year-smoothing averages to remove the effects of technological improvements on wheat yields over time. Climate affects crop growth and development differently over different growth stages. Therefore, we considered the climate effects at both vegetative and reproductive stages (before and after flowering date, respectively) on yield. Cluster analysis was employed to identify the year patterns of climate impact. Five patterns were significantly classified. Precipitation during the vegetative stage was the dominant and beneficial factor for wheat yields while increasing maximum temperature had a negative influence. Crop yields were strongly dependent on solar radiation under normal rainfall conditions. As the effect of rainfall on soil water is relatively long-lasting, its beneficial effect in vegetative stage was higher than its effect during the reproductive stage. The Agricultural Production Systems sIMulator (APSIM) was evaluated using long-term historical data to determine whether the model could reasonably simulate effects of climate factors for each year pattern. The model provided good estimates of wheat yield when conditions resulted in medium yield levels, however, in extremely low or high yield years, corresponding to extremely low or high precipitation in the vegetative stage, the model tended to underestimate or overestimate. Under high growing season precipitation, simulations responded more favourably to reproductive stage rainfall than measured yields. © 2013 Royal Meteorological Society

Organic selenium supplementation increased selenium concentrations in ewe and newborn lamb blood and in slaughter lamb meat compared to inorganic selenium supplementation

Background Selenium is part of the antioxidant defence system in animals and humans. The available selenium concentration in soil is low in many regions of the world. The purpose of this study was to evaluate the effect of organic versus inorganic selenium supplementation on selenium status of ewes, their lambs, and slaughter lambs. Methods Ewes on four organic farms were allocated five or six to 18 pens. The ewes were given either 20 mg/kg inorganic selenium as sodium selenite or organic selenium as selenized nonviable yeast supplementation for the two last months of pregnancy. Stipulated selenium concentrations in the rations were below 0.40 mg/kg dry matter. In addition 20 male lambs were given supplements from November until they were slaughtered in March. Silage, hay, concentrates, and individual ewe blood samples were taken before and after the mineral supplementation period, and blood samples were taken from the newborn lambs. Blood samples from ewes and lambs in the same pens were pooled. Muscle samples were taken from slaughter lambs in March. Selenium concentrations were determined by atomic absorption spectrometry with a hydride generator system. In the ANOVA model, selenium concentration was the continuous response variable, and selenium source and farm were the nominal effect variables. Two-sample t-test was used to compare selenium concentrations in muscle samples from the slaughtered lambs that received either organic or inorganic selenium supplements. Results In all ewe pens the whole blood selenium concentrations increased during the experimental period. In addition, ewe pens that received organic selenium had significantly higher whole blood selenium concentrations (mean 0.28 μg/g) than ewe pens that received inorganic selenium (mean 0.24 μg/g). Most prominent, however, was the difference in their lambs; whole blood mean selenium concentration in lambs from mothers that received organic selenium (mean 0.27 μg/g) was 30% higher than in lambs from mothers that received inorganic selenium (mean 0.21 μg/g). Slaughter lambs that received organic selenium had 50% higher meat selenium concentrations (mean 0.12 mg/kg wet weight) than lambs that received inorganic selenium (mean 0.08 mg/kg wet weight). Conclusion Organic selenium supplementation gave higher selenium concentration in ewe and newborn lamb blood and slaughter lamb meat than inorganic selenium supplementation

A participatory physical and psychosocial intervention for balancing the demands and resources among industrial workers (PIPPI): study protocol of a cluster-randomized controlled trial

Background: Need for recovery and work ability are strongly associated with high employee turnover, well-being and sickness absence. However, scientific knowledge on effective interventions to improve work ability and decrease need for recovery is scarce. Thus, the present study aims to describe the background, design and protocol of a cluster randomized controlled trial evaluating the effectiveness of an intervention to reduce need for recovery and improve work ability among industrial workers. Methods/Design: A two-year cluster randomized controlled design will be utilized, in which controls will also receive the intervention in year two. More than 400 workers from three companies in Denmark will be aimed to be cluster randomized into intervention and control groups with at least 200 workers (at least 9 work teams) in each group. An organizational resources audit and subsequent action planning workshop will be carried out to map the existing resources and act upon initiatives not functioning as intended. Workshops will be conducted to train leaders and health and safety representatives in supporting and facilitating the intervention activities. Group and individual level participatory visual mapping sessions will be carried out allowing team members to discuss current physical and psychosocial work demands and resources, and develop action plans to minimize strain and if possible, optimize the resources. At all levels, the intervention will be integrated into the existing organization of work schedules. An extensive process and effect evaluation on need for recovery and work ability will be carried out via questionnaires, observations, interviews and organizational data assessed at several time points throughout the intervention period. Discussion: This study primarily aims to develop, implement and evaluate an intervention based on the abovementioned features which may improve the work environment, available resources and health of industrial workers, and hence their need for recovery and work ability

Statistical Gaussian Model of Image Regions in Stochastic Watershed Segmentation

International audienceStochastic watershed is an image segmentation technique based on mathematical morphology which produces a probability density function of image contours. Estimated probabilities depend mainly on local distances between pixels. This paper introduces a variant of stochastic watershed where the probabilities of contours are computed from a Gaussian model of image regions. In this framework, the basic ingredient is the distance between pairs of regions, hence a distance between normal distributions. Hence several alternatives of statistical distances for normal distributions are compared, namely Bhattacharyya distance, Hellinger metric distance and Wasserstein metric distance

The Virtual Physiological Human: Ten Years After

Biomedical research and clinical practice are struggling to cope with the growing complexity that the progress of health care involves. The most challenging diseases, those with the largest socioeconomic impact (cardiovascular conditions; musculoskeletal conditions; cancer; metabolic, immunity, and neurodegenerative conditions), are all characterized by a complex genotype–phenotype interaction and by a “systemic” nature that poses a challenge to the traditional reductionist approach. In 2005 a small group of researchers discussed how the vision of computational physiology promoted by the Physiome Project could be translated into clinical practice and formally proposed the term Virtual Physiological Human. Our knowledge about these diseases is fragmentary, as it is associated with molecular and cellular processes on the one hand and with tissue and organ phenotype changes (related to clinical symptoms of disease conditions) on the other. The problem could be solved if we could capture all these fragments of knowledge into predictive models and then compose them into hypermodels that help us tame the complexity that such systemic behavior involves. In 2005 this was simply not possible—the necessary methods and technologies were not available. Now, 10 years later, it seems the right time to reflect on the original vision, the results achieved so far, and what remains to be done

Evaluation of the relationship between the biosecurity status, production parameters, herd characteristics and antimicrobial usage in farrow-to-finish pig production in four EU countries

Background: High antimicrobial usage and the threat of antimicrobial resistance highlighted the need for reduced antimicrobial usage in pig production. Prevention of disease however, is necessary to obtain a reduced need for antimicrobial treatment. This study aimed at assessing possible associations between the biosecurity level, antimicrobial usage and farm and production characteristics in order to advice on best practices for a low antimicrobial usage and maximum animal health and production. A cross-sectional study was conducted in 227 farrow-to-finish pig herds in Belgium, France, Germany and Sweden between December 2012 and December 2013. Associations between biosecurity status, antimicrobial usage, and production parameters were evaluated with multivariable general linear models, according to an assumed causal pathway. Results: The results showed that higher antimicrobial usage in sows tended to be associated with higher antimicrobial usage from birth until slaughter (p = 0.06). The antimicrobial usage from birth until slaughter was positively associated with the number of pathogens vaccinated against (p < 0.01). A shorter farrowing rhythm (p < 0.01) and a younger weaning age (p = 0.06) tended to be also associated with a higher antimicrobial usage from birth until slaughter whereas a better external biosecurity (p < 0.01) was related with a lower antimicrobial usage from birth until slaughter. Conclusion: Management practices such as weaning age and biosecurity measures may be important factors indirectly impacting on antimicrobial usage. We therefore promote a holistic approach when assessing the potential to reduce the need for antimicrobial treatments