Understanding the psychosocial impact of weight loss following bariatric surgery: a qualitative study

Abstract Background Bariatric surgery leads to changes in mental health, quality of life and social functioning, yet these outcomes differ among individuals. In this study, we explore patients’ psychosocial experiences following bariatric surgery and elucidate the individual-level factors that may drive variation in psychosocial outcomes. Methods Eleven semi-structured focus groups with Michigan Bariatric Surgery Collaborative (MBSC) patients (n = 77). Interviews were audio recorded, transcribed verbatim, and analyzed using a grounded theory approach. Data on participant demographic characteristics were abstracted from the MBSC clinical registry. Results Most focus group participants were female (89%), white (64%), and married (65%). We identified three major themes: (1) change in self-perception; (2) change in perception by others; and (3) change in relationships. Each theme includes 3 sub-themes, demonstrating a range of positive and negative psychosocial experiences. For example, weight loss led to increased self-confidence among many participants while others described a loss of self-identity. Some noted improved relationships with family or friends while others experienced worsening or even loss of relationships due to perceived jealousy. Conclusion Weight loss following bariatric surgery leads to complex changes in self-perception and inter-personal relationships, which may be proximal mediators of commonly assessed mental health outcomes such as depression. Individuals considering bariatric surgery may benefit from anticipatory guidance about these diverse experiences, and post-surgical longitudinal monitoring should include evaluation for adverse psychosocial events.https://deepblue.lib.umich.edu/bitstream/2027.42/146725/1/40608_2018_Article_215.pd

Effect of Salinity Stress on Physiological Changes in Winter and Spring Wheat

Salinity is a leading threat to crop growth throughout the world. Salt stress induces altered physiological processes and several inhibitory effects on the growth of cereals, including wheat (Triticum aestivum L.). In this study, we determined the effects of salinity on five spring and five winter wheat genotypes seedlings. We evaluated the salt stress on root and shoot growth attributes, i.e., root length (RL), shoot length (SL), the relative growth rate of root length (RGR-RL), and shoot length (RGR-SL). The ionic content of the leaves was also measured. Physiological traits were also assessed, including stomatal conductance (gs), chlorophyll content index (CCI), and light-adapted leaf chlorophyll fluorescence, i.e., the quantum yield of photosystem II (Fv′/Fm′) and instantaneous chlorophyll fluorescence (Ft). Physiological and growth performance under salt stress (0, 100, and 200 mol/L) were explored at the seedling stage. The analysis showed that spring wheat accumulated low Na+ and high K+ in leaf blades compared with winter wheat. Among the genotypes, Sakha 8, S-24, W4909, and W4910 performed better and had improved physiological attributes (gs, Fv′/Fm′, and Ft) and seedling growth traits (RL, SL, RGR-SL, and RGR-RL), which were strongly linked with proper Na+ and K+ discrimination in leaves and the CCI in leaves. The identified genotypes could represent valuable resources for genetic improvement programs to provide a greater understanding of plant tolerance to salt stress.Salinity is a leading threat to crop growth throughout the world. Salt stress induces altered physiological processes and several inhibitory effects on the growth of cereals, including wheat (Triticum aestivum L.). In this study, we determined the effects of salinity on five spring and five winter wheat genotypes seedlings. We evaluated the salt stress on root and shoot growth attributes, i.e., root length (RL), shoot length (SL), the relative growth rate of root length (RGR-RL), and shoot length (RGR-SL). The ionic content of the leaves was also measured. Physiological traits were also assessed, including stomatal conductance (gs), chlorophyll content index (CCI), and light-adapted leaf chlorophyll fluorescence, i.e., the quantum yield of photosystem II (Fv′ /Fm′ ) and instantaneous chlorophyll fluorescence (Ft). Physiological and growth performance under salt stress (0, 100, and 200 mol/L) were explored at the seedling stage. The analysis showed that spring wheat accumulated low Na+ and high K+ in leaf blades compared with winter wheat. Among the genotypes, Sakha 8, S-24, W4909, and W4910 performed better and had improved physiological attributes (gs, Fv′ /Fm′, and Ft) and seedling growth traits (RL, SL, RGR-SL, and RGR-RL), which were strongly linked with proper Na+ and K+ discrimination in leaves and the CCI in leaves. The identified genotypes could represent valuable resources for genetic improvement programs to provide a greater understanding of plant tolerance to salt stress

Perception regarding needle stick and sharp injuries among clinical year medical students

Introduction: Medical students are exposed to needle stick and sharp injuries (NSSIs) in their everyday routine whether in handling sharp medical instruments or contacting with patients. Thus, it is important to assess the perception of medical students regarding needle stick and sharp injuries, as it is an important feedback to medical school on the effectiveness of their teaching in reducing NSSIs. Objective: To determine the level of perception regarding NSSIs among clinical year’s medical students in a public university, and its association with the knowledge an attitude towards NSSIs. Materials and Methods: A cross sectional study was conducted among 320 clinical year’s medical students from a local public university in Malaysia. The respondents were selected according to the year of study by using stratified random sampling. The study was conducted in May and June 2011 for a period of two months. Self-administrated questionnaires were used in the study. The questionnaires were developed by researchers, and were pre-tested among nursing students in one of the local hospital. Results: Response rate was 93.8%, in which 300 out of 320 respondents were participating in the study. The result showed that 51% of respondents attained good level of perception regarding NSSIs. Meanwhile 53.3% achieved good level of attitude and 55.3% of the respondents attained good knowledge level towards NSSIs. The 5th year medical students got the highest level of perception (21%) on NSSIs as compared to 4th year (10%) and 3rd year (19.6%).There is significant association between level of perception and year of study (P= 0.002) as well as between level of perception and level of knowledge (P = 0.001) and attitude (P ˂ 0.001). Conclusion: Overall there were high proportion of clinical year medical students are having inappropriate perception, unsatisfactory knowledge and inappropriate attitude toward NSSIs. Knowledge and attitude regarding NSSIs showed significant association with perception toward NSSIs

Utilization of natural dyes from Zingiber officinale leaves and Clitoria ternatea flowers to prepare new photosensitisers for dye-sensitised solar cells

Chlorophyll and ternatin were extracted from Zingiber officinale leaves and Clitoria ternatea flowers respectively. These natural dyes were applied as sensitisers in TiO2-based dye-sensitised solar cells (DSSCs). Among 10 different solvents, the ethanol extracts revealed the highest absorption spectra of natural dyes extracted from Z. officinale and C. ternatea. A major effect of temperature increase was the increased extraction yield. High chlorophyll and ternatin yields were obtained under extraction temperatures of 80 °C and 70 °C, respectively. A notable decrease in C. ternatea dye concentration at temperatures >70 °C was also observed. High dye concentrations were obtained using acidic extraction solutions, particularly those with a pH value of 4. Experimental results showed that the DSSC fabricated with chlorophyll extracted from Z. officinale leaves exhibited a conversion efficiency of 0.30%, open-circuit voltage (Voc) of 0.56 V, short-circuit current (Isc) of 0.8 mA/cm−2 and fill factor (FF) of 57.93%. The DSSC sensitized with ternatin from C. ternatea flowers displayed a conversion efficiency of 0.13%, Voc of 0.54 V, Isc of 0.3 mA/cm−2 and FF of 81.82%

Evaluating the Feasibility of Pro-Neurotensin and 25-Hydroxyvitamin D3 as Possible Indicators for Type 2 Diabetes Mellitus and Its Complications

(1) Background: Type 2 diabetes mellitus (T2DM) and metabolic syndrome are associated with decreased vitamin D. In contrast, high pro-neurotensin (pro-NT) levels are linked with an increased risk of T2DM and cardiovascular disease. We aimed to determine the validity of pro-NT and 25-dihydroxy vitamin D3 levels as predictors for T2DM complications; (2) Methods: One hundred T2DM, and one hundred healthy volunteers participated in this case-control study. Their Pro-NT and 25-hydroxyvitamin D3 levels were evaluated using the ELISA technique; (3) Results: Pro-NT and 25 (OH) vitamin D3 have significant validity and accuracy in T2DM prediction, 84.5%, and 90.5%, respectively (p = 0.001). At a value of \u3c29.5, 25-Hydroxy vitamin D3 showed 88% sensitivity and 93% specificity in predicting T2DM. At a value of \u3e124 Pmol/L, Pro-NT showed 81% sensitivity and 88% specificity in predicting T2DM. At a value of 16.5, 25-Hydroxy vitamin D3 had 78.4% sensitivity and 68.3% specificity in predicting T2DM complications. At a value of \u3e158 pmol/L, Pro-NT predicted T2DM complications with 67.6% sensitivity and 56.0% specificity; (4) Conclusions: 25 (OH) Vit D3 and Pro-NT could identify T2DM patients and predict T2DM complications. More extensive research is required to adequately validate this novel perspective with a large population study

Genetic mapping of quantitative trait loci for end-use quality and grain minerals in hard red winter wheat

To meet the demands of different wheat-based food products, traits related to end-use quality become indispensable components in wheat improvement. Thus, markers associated with these traits are valuable for the timely evaluation of protein content, kernel physical characteristics, and rheological properties. Hereunder, we report the mapping results of quantitative trait loci (QTLs) linked to end-use quality traits. We used a dense genetic map with 5199 SNPs from a 90K array based on a recombinant inbred line (RIL) population derived from ‘CO960293-2’/‘TAM 111’. The population was evaluated for flour protein concentration, kernel characteristics, dough rheological properties, and grain mineral concentrations. An inclusive composite interval mapping model for individual and across-environment QTL analyses revealed 22 consistent QTLs identified in two or more environments. Chromosomes 1A, 1B, and 1D had clustered QTLs associated with rheological parameters. Glu-D1 loci from CO960293-2 and either low-molecular-weight glutenin subunits or gliadin loci on 1A, 1B, and 1D influenced dough mixing properties substantially, with up to 34.2% of the total phenotypic variation explained (PVE). A total of five QTLs associated with grain Cd, Co, and Mo concentrations were identified on 3B, 5A, and 7B, explaining up to 11.6% of PVE. The results provide important genetic resources towards understanding the genetic bases of end-use quality traits. Information about the novel and consistent QTLs provided solid foundations for further characterization and marker designing to assist selections for end-use quality improvements.Horticulture and Landscape Architectur

Retrieving Aerosol Characteristics From the PACE Mission, Part 1: Ocean Color Instrument

NASA’s Plankton, Aerosol, Clouds, ocean Ecosystem (PACE) satellite mission is scheduled to launch in 2022, with the Ocean Color Instrument (OCI) on board. For the first time reflected sunlight from the Earth across a broad spectrum from the ultraviolet (UV: 350 nm) to the short wave infrared (SWIR: 2260 nm) will be measured from a single instrument at 1 km spatial resolution. While seven discrete bands will represent the SWIR, the spectrum from 350 to 890 nm will be continuously covered with a spectral resolution of 5 nm. OCI will thus combine in a single instrument (and at an enhanced spatial resolution for the UV) the heritage capabilities of the Moderate resolution Imaging Spectroradiometer (MODIS) and the Ozone Monitoring Instrument (OMI), while covering the oxygen A-band (O2A). Designed for ocean color and ocean biology retrievals, OCI also enables continuation of heritage satellite aerosol products and the development of new aerosol characterization from space. In particular the combination of MODIS and OMI characteristics allows deriving aerosol height, absorption and optical depth along with a measure of particle size distribution. This is achieved by using the traditional MODIS visible-to-SWIR wavelengths to constrain spectral aerosol optical depth and particle size. Extrapolating this information to the UV channels allows retrieval of aerosol absorption and layer height. A more direct method to derive aerosol layer height makes use of O2A absorption methods, despite the relative coarseness of the nominal 5 nm spectral resolution of OCI. Altogether the PACE mission with OCI will be an unprecedented opportunity for aerosol characterization that will continue climate data records from the past decades and propel aerosol science forward toward new opportunities

Gravitational radiation from gamma-ray bursts as observational opportunities for LIGO and VIRGO

Gamma-ray bursts are believed to originate in core-collapse of massive stars. This produces an active nucleus containing a rapidly rotating Kerr black hole surrounded by a uniformly magnetized torus represented by two counter-oriented current rings. We quantify black hole spin-interactions with the torus and charged particles along open magnetic flux-tubes subtended by the event horizon. A major output of Egw=4e53 erg is radiated in gravitational waves of frequency fgw=500 Hz by a quadrupole mass-moment in the torus. Consistent with GRB-SNe, we find (i) Ts=90s (tens of s, Kouveliotou et al. 1993), (ii) aspherical SNe of kinetic energy Esn=2e51 erg (2e51 erg in SN1998bw, Hoeflich et al. 1999) and (iii) GRB-energies Egamma=2e50 erg (3e50erg in Frail et al. 2001). GRB-SNe occur perhaps about once a year within D=100Mpc. Correlating LIGO/Virgo detectors enables searches for nearby events and their spectral closure density 6e-9 around 250Hz in the stochastic background radiation in gravitational waves. At current sensitivity, LIGO-Hanford may place an upper bound around 150MSolar in GRB030329. Detection of Egw thus provides a method for identifying Kerr black holes by calorimetry.Comment: to appear in PRD, 49

Global, regional, and national burden of chronic kidney disease, 1990–2017 : a systematic analysis for the Global Burden of Disease Study 2017

Background Health system planning requires careful assessment of chronic kidney disease (CKD) epidemiology, but data for morbidity and mortality of this disease are scarce or non-existent in many countries. We estimated the global, regional, and national burden of CKD, as well as the burden of cardiovascular disease and gout attributable to impaired kidney function, for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. We use the term CKD to refer to the morbidity and mortality that can be directly attributed to all stages of CKD, and we use the term impaired kidney function to refer to the additional risk of CKD from cardiovascular disease and gout. Methods The main data sources we used were published literature, vital registration systems, end-stage kidney disease registries, and household surveys. Estimates of CKD burden were produced using a Cause of Death Ensemble model and a Bayesian meta-regression analytical tool, and included incidence, prevalence, years lived with disability, mortality, years of life lost, and disability-adjusted life-years (DALYs). A comparative risk assessment approach was used to estimate the proportion of cardiovascular diseases and gout burden attributable to impaired kidney function. Findings Globally, in 2017, 1·2 million (95% uncertainty interval [UI] 1·2 to 1·3) people died from CKD. The global all-age mortality rate from CKD increased 41·5% (95% UI 35·2 to 46·5) between 1990 and 2017, although there was no significant change in the age-standardised mortality rate (2·8%, −1·5 to 6·3). In 2017, 697·5 million (95% UI 649·2 to 752·0) cases of all-stage CKD were recorded, for a global prevalence of 9·1% (8·5 to 9·8). The global all-age prevalence of CKD increased 29·3% (95% UI 26·4 to 32·6) since 1990, whereas the age-standardised prevalence remained stable (1·2%, −1·1 to 3·5). CKD resulted in 35·8 million (95% UI 33·7 to 38·0) DALYs in 2017, with diabetic nephropathy accounting for almost a third of DALYs. Most of the burden of CKD was concentrated in the three lowest quintiles of Socio-demographic Index (SDI). In several regions, particularly Oceania, sub-Saharan Africa, and Latin America, the burden of CKD was much higher than expected for the level of development, whereas the disease burden in western, eastern, and central sub-Saharan Africa, east Asia, south Asia, central and eastern Europe, Australasia, and western Europe was lower than expected. 1·4 million (95% UI 1·2 to 1·6) cardiovascular disease-related deaths and 25·3 million (22·2 to 28·9) cardiovascular disease DALYs were attributable to impaired kidney function. Interpretation Kidney disease has a major effect on global health, both as a direct cause of global morbidity and mortality and as an important risk factor for cardiovascular disease. CKD is largely preventable and treatable and deserves greater attention in global health policy decision making, particularly in locations with low and middle SDI

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London