Assessment of electrolyte imbalance among benign prostate hyperplasia patients in Western Kenya

Background: Benign prostate hyperplasia (BPH) results in the enlargement of the gland and ultimately obstructs the bladder and the kidney. The effect on the kidney results in the dysregulation of the electrolyte causing electrolyte imbalance. Methods: An analytical cross-sectional study conducted at a tertiary teaching hospital aimed at assessing the levels and severity of electrolyte imbalance among BPH patients. The blood samples were analyzed for electrolytes and PSA levels for both patients and control group. An Independent t-test was used to compare the means of the BPH patients and healthy control subjects. Chi-square was used to determine the association between the electrolyte imbalance and the PSA levels of the BPH patients. Results: The mean age of the BPH patients and the healthy individuals was 65.47±12.55 and 64.52±12.19 years respectively. Hyponatremia, and hypernatremia were observed in 26.08% (n=104) and 4.22% (n=8) of the BPH patients respectively. There was a statistical significance positive correlation between potassium (K) and sodium (Na) concentrations (r=0.350, p<0.01), as well as a notable positive association between chloride (Cl) and magnesium (Mg) levels (r=0.288, p<0.01). PSA biomarker levels varied among the patients. There was a statistical significance (<0.0001*) difference in PSA levels between the BPH patients and the control group. Conclusions: With high prevalence of electrolyte imbalance among BPH patients there is a need to monitor the electrolytes and PSA levels in the management of BPH aiming at restoration of kidney function

Soybean seed protein concentration is limited by nitrogen supply in tropical and subtropical environments in Brazil

Soybean production contributes to ca. 60% of global plant-based protein used for food and feed. Brazil is the largest soybean producer and exporter, with 60% from tropical and 40% from subtropical environments. Nitrogen (N) can play an essential role in the storage of proteins in seeds; thus, it could be a key factor in increasing the quantity and quality of seeds in high-yielding soybean crops. Unlike in temperate environments, there is a gap of knowledge on whether soybean grown under tropical and subtropical climates are limited by N-fertilization to sustain the seed yield increase without detriments in seed protein concentration. This study aimed to evaluate the effect of N-fertilization on soybean seed yield, protein, and oil concentrations in tropical and subtropical environments in Brazil, thus contributing to agricultural intensification procedures and food security studies. Two levels of N-fertilization (0 and 1000 ka/ha) were tested across 11 tropical or subtropical environments. The range of latitudes explored here was from 12º S to 29º S, representing the major soybean-producing regions in Brazil either under rainfed or irrigated conditions. We found that seed yield responses to N-fertilization were significant (in some environments under rainfed with an average increase of 7%) or not significant (in irrigated). Seed protein increases due to improved N-fertilization (on average 4% for irrigated and 12% for rainfed conditions) were much higher than previous reports from temperate environments. Regardless of N supply and water deficit, there was a trend of seed protein and oil concentration increasing toward lower latitudes

Contingency management to reduce methamphetamine use and sexual risk among men who have sex with men: a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Methamphetamine use is associated with HIV acquisition and transmission among men who have sex with men (MSM). Contingency management (CM), providing positive reinforcement for drug abstinence and withholding reinforcement when abstinence is not demonstrated, may facilitate reduced methamphetamine use and sexual risk. We compared CM as a stand-alone intervention to a minimal intervention control to assess the feasibility of conducting a larger, more definitive trial of CM; to define the frequency of behavioral outcomes to power such a trial; and, to compute preliminary estimates of CM's effectiveness.</p> <p>Methods</p> <p>We randomly assigned 127 MSM from Seattle, WA who use methamphetamine to receive a 12-week CM intervention (n = 70) or referral to community resources (n = 57).</p> <p>Results</p> <p>Retention at 24 weeks was 84%. Comparing consecutive study visits, non-concordant UAI declined significantly in both study arms. During the intervention, CM and control participants were comparably likely to provide urine samples containing methamphetamine (adjusted relative risk [aRR] = 1.09; 95%CI: 0.71, 1.56) and to report non-concordant UAI (aRR = 0.80; 95%CI: 0.47, 1.35). However, during post-intervention follow-up, CM participants were somewhat more likely to provide urine samples containing methamphetamine than control participants (aRR = 1.21; 95%CI: 0.95, 1.54, <it>P </it>= 0.11). Compared to control participants, CM participants were significantly more likely to report weekly or more frequent methamphetamine use and use of more than eight quarters of methamphetamine during the intervention and post-intervention periods.</p> <p>Conclusions</p> <p>While it is possible to enroll and retain MSM who use methamphetamine in a trial of CM conducted outside drug treatment, our data suggest that CM is not likely to have a large, sustained effect on methamphetamine use.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov Identifier <b>NCT01174654</b></p

Irrigation increases on-farm soybean yields in water-limited environments without a trade-off in seed protein concentration

Context or problem: A trade-off between seed protein concentration (SPC) and yield has been reported for soybean. Therefore, assessing management practices that can nullify this trade-off is relevant to avoid further declines in SPC in the future as yield continues to increase. While the positive effect of irrigation on yield is well documented, only a few studies have assessed the impact of irrigation on SPC, showing conflicting results. Objective or research question: The objective was to determine if the trade-off between seed yield and SPC persists when irrigation is applied and how management, soil, and weather factors influence the trade-off. We hypothesized that yield increases induced by irrigation would likely decrease SPC. Methods: Our experimental approach involved the use of producer-reported data, in-situ seed collection, and crop modeling. Yield and management data were collected from 268 soybean fields in Nebraska (USA), along with data on SPC, seed oil concentration (SOC), and seed carbohydrate concentration (SCC) determined from samples collected in each field. Field-specific phenological data were derived from model simulations. The combined data were then used to assess the effect of irrigation on seed yield and constituents as influenced by management, soil, and weather factors. Results: On average, both seed yield (+0.86 Mg ha-1) and SPC (+3.2 g kg-1) were higher, but SOC (–2.0 g kg-1) was lower, and SCC was unaffected in irrigated versus rainfed field pairs. Yield and SPC increased simultaneously in response to irrigation in two-thirds of the fields, especially when environmental conditions did not favor seed oil synthesis (e.g., cooler temperature and less incident solar radiation). A trade-off of higher seed yield and lower SPC occurred with irrigation in the remaining fields wherein conditions were favorable for seed oil synthesis (e. g., warmer temperatures and greater radiation). Conclusions: Despite higher seed yield generated in irrigated versus rainfed fields, no concurrent reduction occurred in SPC in the majority of irrigated fields – a surprising finding that was not consistent with the general expectation that higher soybean yields typically result in yield-SPC trade-off. Implications or significance: This study showed that irrigation-induced higher soybean yields are possible without an attendant SPC penalty when temperatures and radiation are conducive for its mitigation. We are unaware of any other yield-increasing practices – except nitrogen (N) fertilization - that do not result in a concomitant decline in SPC. A hypothesized higher N supply via soil N mineralization and/or biological N fixation in irrigated fields in this study may explain the absence of yield-protein trade-off

Symptoms and quality of life in late stage Parkinson syndromes: a longitudinal community study of predictive factors

BACKGROUND Palliative care is increasingly offered earlier in the cancer trajectory but rarely in Idiopathic Parkinson's Disease(IPD), Progressive Supranuclear Palsy(PSP) or Multiple System Atrophy(MSA). There is little longitudinal data of people with late stage disease to understand levels of need. We aimed to determine how symptoms and quality of life of these patients change over time; and what demographic and clinical factors predicted changes. METHODS We recruited 82 patients into a longitudinal study, consenting patients with a diagnosis of IPD, MSA or PSP, stages 3-5 Hoehn and Yahr(H&Y). At baseline and then on up to 3 occasions over one year, we collected self-reported demographic, clinical, symptom, palliative and quality of life data, using Parkinson's specific and generic validated scales, including the Palliative care Outcome Scale (POS). We tested for predictors using multivariable analysis, adjusting for confounders. FINDINGS Over two thirds of patients had severe disability, over one third being wheelchair-bound/bedridden. Symptoms were highly prevalent in all conditions - mean (SD) of 10.6(4.0) symptoms. More than 50% of the MSA and PSP patients died over the year. Over the year, half of the patients showed either an upward (worsening, 24/60) or fluctuant (8/60) trajectory for POS and symptoms. The strongest predictors of higher levels of symptoms at the end of follow-up were initial scores on POS (AOR 1.30; 95%CI:1.05-1.60) and being male (AOR 5.18; 95% CI 1.17 to 22.92), both were more predictive than initial H&Y scores. INTERPRETATION The findings point to profound and complex mix of non-motor and motor symptoms in patients with late stage IPD, MSA and PSP. Symptoms are not resolved and half of the patients deteriorate. Palliative problems are predictive of future symptoms, suggesting that an early palliative assessment might help screen for those in need of earlier intervention

Dark solitons in atomic Bose-Einstein condensates: from theory to experiments

This review paper presents an overview of the theoretical and experimental progress on the study of matter-wave dark solitons in atomic Bose-Einstein condensates. Upon introducing the general framework, we discuss the statics and dynamics of single and multiple matter-wave dark solitons in the quasi one-dimensional setting, in higher-dimensional settings, as well as in the dimensionality crossover regime. Special attention is paid to the connection between theoretical results, obtained by various analytical approaches, and relevant experimental observations.Comment: 82 pages, 13 figures. To appear in J. Phys. A: Math. Theor

Nonlinear Waves in Bose-Einstein Condensates: Physical Relevance and Mathematical Techniques

The aim of the present review is to introduce the reader to some of the physical notions and of the mathematical methods that are relevant to the study of nonlinear waves in Bose-Einstein Condensates (BECs). Upon introducing the general framework, we discuss the prototypical models that are relevant to this setting for different dimensions and different potentials confining the atoms. We analyze some of the model properties and explore their typical wave solutions (plane wave solutions, bright, dark, gap solitons, as well as vortices). We then offer a collection of mathematical methods that can be used to understand the existence, stability and dynamics of nonlinear waves in such BECs, either directly or starting from different types of limits (e.g., the linear or the nonlinear limit, or the discrete limit of the corresponding equation). Finally, we consider some special topics involving more recent developments, and experimental setups in which there is still considerable need for developing mathematical as well as computational tools.Comment: 69 pages, 10 figures, to appear in Nonlinearity, 2008. V2: new references added, fixed typo

EQUIP: Implementing chronic care principles and applying formative evaluation methods to improve care for schizophrenia: QUERI Series

<p>Abstract</p> <p>Background</p> <p>This paper presents a case study that demonstrates the evolution of a project entitled "Enhancing QUality-of-care In Psychosis" (EQUIP) that began approximately when the U.S. Department of Veterans Affairs' Quality Enhancement Research Initiative (QUERI), and implementation science were emerging. EQUIP developed methods and tools to implement chronic illness care principles in the treatment of schizophrenia, and evaluated this implementation using a small-scale controlled trial. The next iteration of the project, EQUIP-2, was further informed by implementation science and the use of QUERI tools.</p> <p>Methods</p> <p>This paper reports the background, development, results and implications of EQUIP, and also describes ongoing work in the second phase of the project (EQUIP-2). The EQUIP intervention uses implementation strategies and tools to increase the adoption and implementation of chronic illness care principles. In EQUIP-2, these strategies and tools are conceptually grounded in a stages-of-change model, and include clinical and delivery system interventions and adoption/implementation tools. Formative evaluation occurs in conjunction with the intervention, and includes developmental, progress-focused, implementation-focused, and interpretive evaluation.</p> <p>Results</p> <p>Evaluation of EQUIP provided an understanding of quality gaps <it>and </it>how to address related problems in schizophrenia. EQUIP showed that solutions to quality problems in schizophrenia differ by treatment domain and are exacerbated by a lack of awareness of evidence-based practices. EQUIP also showed that improving care requires creating resources for physicians to help them easily implement practice changes, plus intensive education as well as product champions who help physicians use these resources. Organizational changes, such as the addition of care managers and informatics systems, were shown to help physicians with identifying problems, making referrals, and monitoring follow-up. In EQUIP-2, which is currently in progress, these initial findings were used to develop a more comprehensive approach to implementing and evaluating the chronic illness care model.</p> <p>Discussion</p> <p>In QUERI, small-scale projects contribute to the development and enhancement of hands-on, action-oriented service-directed projects that are grounded in current implementation science. This project supports the concept that QUERI tools can be useful in implementing complex care models oriented toward evidence-based improvement of clinical care.</p

Do parkinsonian patients have trouble telling lies? The neurobiological basis of deceptive behaviour

Parkinson's disease is a common neurodegenerative disorder with both motor symptoms and cognitive deficits such as executive dysfunction. Over the past 100 years, a growing body of literature has suggested that patients with Parkinson's disease have characteristic personality traits such as industriousness, seriousness and inflexibility. They have also been described as ‘honest’, indicating that they have a tendency not to deceive others. However, these personality traits may actually be associated with dysfunction of specific brain regions affected by the disease. In the present study, we show that patients with Parkinson's disease are indeed ‘honest’, and that this personality trait might be derived from dysfunction of the prefrontal cortex. Using a novel cognitive task, we confirmed that patients with Parkinson's disease (n = 32) had difficulty making deceptive responses relative to healthy controls (n = 20). Also, using resting-state 18F-fluorodeoxyglucose PET, we showed that this difficulty was significantly correlated with prefrontal hypometabolism. Our results are the first to demonstrate that the ostensible honesty found in patients with Parkinson's disease has a neurobiological basis, and they provide direct neuropsychological evidence of the brain mechanisms crucial for human deceptive behaviour