Micronutrient Deficiencies in Medical and Surgical Inpatients

Inpatients are threatened by global malnutrition, but also by specific micronutrient (i.e., trace element and vitamins) deficiencies that frequently are overseen in the differential diagnosis of major organ dysfunctions. Some of them are related to specific geographic risks (iodine, iron, selenium, zinc, vitamin A), while others are pathology related, and finally many are associated with specific feeding patterns, including low dose enteral feeding. Among the pathologies in which laboratory blood investigations should include a micronutrient outwork, anemia is in the front line, followed by obesity with bariatric surgery, chronic liver disease, kidney disease, inflammatory bowel disease, cardiomyopathies and heart failure. The micronutrients at the highest risk are iron, zinc, thiamine, vitamin B12 and vitamin C. Admission to hospital has been linked with an additional risk of malnutrition-feeding below 1500 kcal/day was frequent and has been associated with a structural additional risk of insufficient micronutrient intake to cover basal needs. Although not evidence based, systematic administration of liberal thiamine doses upon admission, and daily complementation of inpatients' food and enteral feeding solutions with multi-micronutrient tablets might be considered

Stochastic frontiers of efficiency for Brazilian investment funds: A panel data analysis

Foundations, methodological and empirical possibilities of measurement and analysis in the performance of financial investments within investment funds have been developed since they were once introduced in the 1970s, thus establishing a path of growing acceptance in financial markets and universities'' academies. The first approaches over the efficiency of these funds, considering their stochastic implications, occurred in the late 1990s and have evolved with the help of SFA - Stochastic Frontier Analysis, although it still needs more careful verification. This article measured and analyzed the stochastic frontier of efficiency over 33 different Brazilian investment funds from 2012 to 2015. For doing so, Battese and Coelli's (1995) specifications was used. It shows the effects of inefficiencies, which are defined as explicit functions of specific factors in the context of panel data funds. They are estimated by the maximum likelihood method. Sharpe ratios (SR) were also calculated for comparative purposes. Based on these two indicators (SFA and SR), the most recommendable funds to invest and the ones in which the application should not be performed were identified. Such procedures have stimulated the necessary and promising studies, as well as future researches, which, in turn, may establish new methodological formulation as an efficient and effective instrument to choose the best and the safest funds to invest

Nested shallow geothermal systems

The long-term sustainability of shallow geothermal systems in dense urbanized areas can be potentially compromised by the existence of thermal interfaces. Thermal interferences between systems have to be avoided to prevent the loss of system performance. Nevertheless, in this work we provide evidence of a positive feedback from thermal interferences in certain controlled situations. Two real groundwater heat pump systems were investigated using real exploitation data sets to estimate the thermal energy demand bias and, by extrapolation, to assess the nature of thermal interferences between the systems. To do that, thermal interferences were modelled by means of a calibrated and validated 3D city-scale numerical model reproducing groundwater flow and heat transport. Results obtained showed a 39% (522 MWh·yr-1) energy imbalance towards cooling for one of the systems, which generated a hot thermal plume towards the downgradient and second system investigated. The nested system in the hot thermal plume only used groundwater for heating, thus establishing a positive symbiotic relationship between them. Considering the energy balance of both systems together, a reduced 9% imbalance was found, hence ensuring the long-term sustainability and renewability of the shallow geothermal resource exploited. The nested geothermal systems described illustrate the possibilities of a new management strategy in shallow geothermal energy governance

Controlling the gain contribution of background emitters in few-quantum-dot microlasers

Funding: European Research Council under the European Union's Seventh Framework ERC Grant Agreement No. 615613; German Research Foundation via Grant-No.: Re2974/10-1, Gi1121/1-1.We provide experimental and theoretical insight into single-emitter lasing effects in a quantum dot (QD)-microlaser under controlled variation of background gain provided by off-resonant discrete gain centers. For that purpose, we apply an advanced two-color excitation concept where the background gain contribution of off-resonant QDs can be continuously tuned by precisely balancing the relative excitation power of two lasers emitting at different wavelengths. In this way, by selectively exciting a singleresonant QD and off-resonant QDs, we identify distinct single-QD signatures in the lasing characteristics and distinguish between gain contributions of a single resonant emitter and a countable number of offresonant background emitters to the optical output of the microlaser. Our work addresses the importantquestion whether single-QD lasing is feasible in experimentally accessible systems and shows that, for the investigated microlaser, the single-QD gain needs to be supported by the background gain contribution ofoff-resonant QDs to reach the transition to lasing. Interestingly, while a single QD cannot drive the investigated micropillar into lasing, its relative contribution to the emission can be as high as 70% and it dominates the statistics of emitted photons in the intermediate excitation regime below threshold.Publisher PDFPeer reviewe

The primary cilium influences interleukin-1 beta-induced NF kappa B signalling by regulating IKK activity

AbstractThe primary cilium is an organelle acting as a master regulator of cellular signalling. We have previously shown that disruption of primary cilia assembly, through targeting intraflagellar transport, is associated with muted nitric oxide and prostaglandin responses to the inflammatory cytokine interleukin-1β (IL-1β). Here, we show that loss of the primary cilium disrupts specific molecular signalling events in cytosolic NFκB signalling. The induction of cyclooxygenase 2 (COX2) and inducible nitrous oxide synthase (iNOS) protein is abolished. Cells unable to assemble cilia exhibit unaffected activation of IκB kinase (IKK), but delayed and reduced degradation of IκB, due to diminished phosphorylation of inhibitor of kappa B (IκB) by IKK. This results in both delayed and reduced NFκB p65 nuclear translocation and nuclear transcript binding. We also demonstrate that heat shock protein 27 (hsp27), an established regulator of IKK, is localized to the ciliary axoneme and cellular levels are dramatically disrupted with loss of the primary cilium. These results suggest that the primary cilia compartment exerts influence over NFκB signalling. We propose that the cilium is a locality for regulation of the molecular events defining NFκB signalling events, tuning signalling as appropriate

The β3-integrin endothelial adhesome regulates microtubule-dependent cell migration

Integrin β3 is seen as a key anti-angiogenic target for cancer treatment due to its expression on neovasculature, but the role it plays in the process is complex; whether it is pro- or anti-angiogenic depends on the context in which it is expressed. To understand precisely β3's role in regulating integrin adhesion complexes in endothelial cells, we characterised, by mass spectrometry, the β3-dependent adhesome. We show that depletion of β3-integrin in this cell type leads to changes in microtubule behaviour that control cell migration. β3-integrin regulates microtubule stability in endothelial cells through Rcc2/Anxa2-driven control of active Rac1 localisation. Our findings reveal that angiogenic processes, both in vitro and in vivo, are more sensitive to microtubule targeting agents when β3-integrin levels are reduced

Uncoupled continuous-time random walks: Solution and limiting behavior of the master equation

A detailed study is presented for a large class of uncoupled continuous-time random walks (CTRWs). The master equation is solved for the Mittag-Leffler survival probability. The properly scaled diffusive limit of the master equation is taken and its relation with the fractional diffusion equation is discussed. Finally, some common objections found in the literature are thoroughly reviewed.Comment: Preprint version of an already published paper. 8 page

A U-HPLC-ESI-MS/MS-based stable isotope dilution method for the detection and quantitation of methotrexate in plasma

INTRODUCTION: High-dose methotrexate (MTX) is used in the treatment of proliferative diseases such as acute lymphoblastic leukemia. Therapeutic drug monitoring of plasma MTX is important to monitor efficacy and adverse events. The authors aimed to develop a liquid chromatography, electrospray ionization, tandem mass spectrometry (LC-ESI-MS/MS)-based method to determine MTX in plasma for therapeutic drug monitoring and pharmacokinetic studies. METHODS: Samples were analyzed using a Waters Acquity UPLC and Quattro Premier XE. A Waters Acquity UPLC BEH C18 column (2.1 mm x 100 mm, 1.7 μm) was used running an isocratic mobile phase of 21% methanol and 10 mM ammonium bicarbonate. The electrospray was operated in the positive ionization mode monitoring the following mass transitions: m/z 455.2 > 308.2 for MTX and m/z 458.2 > 311.2 for MTXd3. The analysis combined straightforward sample preparation, consisting of dilution and protein precipitation, with a 3-minute run time. RESULTS: The method was linear up to 50 μM (r > 0.99), and the coefficient of variation was 1:10, was 5 nM. Method comparison with the Abbott TDx fluorescent polarization immunoassay (FPIA) showed excellent agreement, and a small but significant negative constant bias was detected (LC-MS/MS = 0.98 x FPIA - 7.3). CONLUSIONS: The authors developed a specific and sensitive stable isotope dilution LC-ESI-MS/MS method to monitor MTX concentrations in plasma within the clinically relevant range. The method can be easily applied in clinical laboratories because it combines straightforward sample pretreatment with LC-MS/MS. Copyrigh