Papel de los factores psicológicos en la diabetes mellitus: morbilidad psiquiátrica y perfil psicopatológico

Una población de diabéticos jóvenes, sus madres y hermanos completaron dos inventarios para determinar si existían diferencias en cuanto a morbilidad psiquiátrica y al perfil psicopatológico. Los resultados indican que los pacientes diabéticos mostraban menor morbilidad psiquiátrica que sus madres. Entre sus hermanos no se observó ninguno que cumpliera criterios de caso psiquiátrico. Se realizan pruebas t y análisis de la varianza para estudiar las diferencias entre los tres grupos y se detecta que las variables depresión y somatización distinguen entre diabéticos y no diabéticos, mientras que entre el grupo de madres y sus hijos diabéticos se observaron diferencias significativas en las escalas que conforman la triada neurótica, la psicastenia y la introversión social

Altered umbilical cord blood nutrient levels, placental cell turnover and transporter expression in human term pregnancies conceived by intracytoplasmic sperm injection (Icsi)

Assisted reproductive technologies (ART) may increase risk for abnormal placental development, preterm delivery and low birthweight. We investigated placental morphology, transporter expression and paired maternal/umbilical fasting blood nutrient levels in human term pregnancies conceived naturally (n = 10) or by intracytoplasmic sperm injection (ICSI; n = 11). Maternal and umbilical vein blood from singleton term (>37 weeks) C-section pregnancies were assessed for levels of free amino acids, glucose, free fatty acids (FFA), cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), very low-density lipoprotein (VLDL) and triglycerides. We quantified placental expression of GLUT1 (glucose), SNAT2 (amino acids), P-glycoprotein (P-gp) and breast cancer resistance protein (BCRP) (drug) transporters, and placental morphology and pathology. Following ICSI, placental SNAT2 protein expression was downregulated and umbilical cord blood levels of citrulline were increased, while FFA levels were decreased at term (p < 0.05). Placental proliferation and apoptotic rates were increased in ICSI placentae (p < 0.05). No changes in maternal blood nutrient levels, placental GLUT1, P-gp and BCRP expression, or placental histopathology were observed. In term pregnancies, ICSI impairs placental SNAT2 transporter expression and cell turnover, and alters umbilical vein levels of specific nutrients without changing placental morphology. These may represent mechanisms through which ICSI impacts pregnancy outcomes and programs disease risk trajectories in offspring across the life course

Not all waits are equal: An investigation of emergency care patient pathway.

Abstract Background: Increasing pressure in the United Kingdom (UK) urgent care system has led to Emergency Departments (EDs) failing to meet the national requirement that 95% of patients are admitted, discharged or transferred within 4-h of arrival. Despite the target being the same for all acute hospitals, individual Trusts organise their services in different ways. The impact of this variation on patient journey time and waiting is unknown. Our study aimed to apply the Lean technique of Value Stream Mapping (VSM) to investigate care processes and delays in patient journeys at four contrasting hospitals. Methods: VSM timing data were collected for patients accessing acute care at four hospitals in South West England. Data were categorised according to waits and activities, which were compared across sites to identify variations in practice from the patient viewpoint. We included Public and Patient Involvement (PPI) to fully interpret our findings; observations and initial findings were considered in a PPI workshop. Results: One hundred eight patients were recruited, comprising 25,432 min of patient time containing 4098 episodes of care or waiting. The median patient journey was 223 min (3 h, 43 min); just within the 4-h target. Although total patient journey times were similar between sites, the stage where the greatest proportion of waiting occurred varied. Reasons for waiting were dominated by waits for beds, investigations or results to be available. From our sample we observed that EDs without a discharge/clinical decision area exhibited a greater proportion of waiting time following an admission or discharge decision. PPI interpretation indicated that patients who experience waits at the beginning of their journey feel more anxious because they are ‘not in the system yet’. Conclusions: The novel application of VSM analysis across different hospitals, coupled with PPI interpretation, provides important insight into the impact of care provision on patient experience. Measures that could reduce patient waiting include automatic notification of test results, and the option of discharge/clinical decision areas for patients awaiting results or departure. To enhance patient experience, good communication with patients and relatives about reasons for waits is essential. Keywords: Health service research, Acute care, Emergency admissions, Patient care, Value stream mapping, Emergency department, Patient public involvemen

Dysregulation of placental ABC transporters in a murine model of malaria-induced preterm labor

Malaria in Pregnancy (MiP) is characterized by placental accumulation of Plasmodium-infected erythrocytes, intrauterine growth restriction (IUGR) and preterm delivery (PTD). Placental ATP-binding cassette (ABC) transporters mediate the efflux of nutrients, cytokines and xenobiotics. The expression and activity of these transporters are highly responsive to infection. We hypothesized that MiP would perturb the expression of placental ABC transporters, promoting PTD. Peripheral blood, spleens, livers and placentas of pregnant mice, infected with Plasmodium berghei ANKA on gestational day (GD) 13.5, were collected and analyzed on GD18.5. The primary consequences of human MiP, including IUGR, PTD (20%) and placental inflammation, were recapitulated in our mouse model. Electron microscopy revealed attenuated presence of labyrinthine microvilli and dilated spongiotrophoblasts -granular endoplasmic reticulum cisternae. Additionally, a decrease in placental Abca1 (ABCA1), Abcb1b (P-glycoprotein), Abcb9 and Abcg2 (BCRP) expression was observed in MiP mice. In conclusion, MiP associated with PTD impairs placental ABC transporters’ expression, potentially modulating placental nutrient, environmental toxin and xenobiotic biodistribution within the fetal compartment, and may, at some degree, be involved with pregnancy outcome in MiP

The Efficiency of Refrigeration Capacity Regulation in the Ambient Air Conditioning Systems

The Efficiency of Refrigeration Capacity Regulation in the Ambient Air Conditioning Systems / E. Trushliakov, A. Radchenko, M. Radchenko, S. Kantor, O. Zielikov // Proceedings of the 3rd Intern. Conf. on Design, Simulation, Manufacturing: The Innovation Exchange «Advances in Design, Simulation and Manufacturing III». – Kharkiv, 2020. – Vol. 244. – P. 343–353.Abstract. The operation of the ambient air conditioning systems (ACS) is characterized by considerable fluctuations of the heat load in response to the current climatic conditions. It needs the analyses of the efficiency of the application of compressors with frequency converters for refrigeration capacity regulation in actual climatic conditions. A new method and approach to analyzing the effectiveness of ACS cooling capacity adjusting by using the compressor with changing the rotational speed of the motor as an example have been developed, according to which the overall range of changeable heat loads is divided into two zones: the zone of ambient air processing with considerable fluctuations of the current heat load, that requires effective refrigeration capacity regulation by the compressor with frequency converters (from 100% rated refrigeration capacity down to about 50%) and not an adjustable zone of reduced refrigeration capacity below 50% rated refrigeration capacity of the compressor. The magnitudes of threshold refrigeration capacity between both zones are chosen according to the rational value of installed (design) refrigeration capacity on the ACS, required for cooling the ambient air to a target temperature that ensures the maximum annual refrigeration capacity production in actual current climatic conditions. The proposed method and approach to the analysis of the efficiency of the refrigeration capacity regulation of the ACS compressor by distributing the overall range of changes in current heat loads allows increasing the efficiency of utilizing the installed refrigeration capacity in prevailing climatic conditions

Increasing the Operation Efficiency of Air Conditioning System for Integrated Power Plant on the Base of Its Monitoring

Increasing the Operation Efficiency of Air Conditioning System for Integrated Power Plant on the Base of Its Monitoring / E. Trushliakov, A. Radchenko, S. Forduy, A. Zubarev, A. Hrych // Advances in intelligent systems and computing. – 2020. – Т. 1113 AISC . – P. 351–360Abstract. The efficiency of reciprocating gas engines of integrated energy systems (IES) for combined electricity, heat and refrigeration generation is strictly influenced by their cyclic air temperatures. To evaluate the effect of gas engine cyclic air deep cooling, compared with conventional its cooling, the data on dependence of fuel consumption and power output of gas engine JMS 420 GS-N.L on its inlet air temperature at varying ambient air temperatures at the entrance of the radiator for scavenge air cooling were received. The results of treatment of gas engine efficiency monitoring proved non-effective operation of conventional chilling all the ambient air, coming into the engine room, because of increased air temperature at the inlet of turbocharger (TC), caused by heat influx from surroundings in the engine room. A new method of gas engine inlet air two-stage cooling at increased ambient air temperatures and advanced cyclic air cooling system with absorption lithium-bromide chiller and refrigerant ejector chiller was proposed. With this chilled water from absorption lithiumbromide chiller is used as a coolant in the first high-temperature stage of engine inlet air cooler and boiling refrigerant of ejector chiller in the second lowtemperature stage