Control of hepatic fatty acid oxidation in suckling rats

In this thesis, I use metabolic control analysis to investigate quantitatively, the control of neonatal hepatic fatty acid oxidation and ketogenesis. Specifically, I model, report and discuss the control of hepatic fatty acid oxidation, Krebs cycle and ketogenic fluxes by mitochondrial outer membrane carnitine palmitoyltransferase I (CPT I), in hepatocytes or mitochondria isolated from suckling rats, under physiological and (patho)physiological conditions, mimicking healthy and diseased states. My work has: (a) provided the first quantitative assessment of the control exerted by CPT I over carbon fluxes from palmitate, octanoate and palmitate: octanoate mixtures, in hepatocytes isolated from suckling rats; (b) provided a quantitative assessment of the control exerted by CPT I over ketogenesis and total carbon flux from palmitate, in a re-defined system, in mitochondria isolated from suckling or adult rats (Krauss, et al., 1996); (c) shown that the numerical value of the flux control coefficient for CPT I over ketogenesis changes with developmental stage and is lower in suckling rats than in adult rats in both hepatocyte and mitochondrial systems; (d) demonstrated that the numerical value of the flux control coefficient for CPT I over ketogenesis changes in response to different substrates; (e) indicated that whilst in adult rats, CPT I exerts a high level of control over ketogenesis in neonatal rats, CPT I is not 'rate-limiting' over ketogenesis, under physiological conditions; (f) provided the first quantitative assessment of the control exerted by CPT I over carbon fluxes from palmitate in an in vitro model of neonatal sepsis; (g) demonstrated that the potential of CPT I to control ketogenesis increases under certain (patho)physiological conditions; (h) provided an investigation into hepatocyte respiration under (patho)physiological conditions and has shown that in this in vitro model of neonatal sepsis, oxygen consumption is increased

An Index of Nayrūz Occurrences in Abbasid Literary Sources.

This volume is the result of a two-years research project, focusing on an exhaustive indexing of all edited Arabic sources mentioning the Iranian festival of Nayrūz (Nawrūz) in the Abbasid age (750-1258 CE). The Index is meant as a first step towards filling a void in the study of the Abbasid age, providing a ground-breaking instrument for scholars interested in the study of chronology and socio-economical history of the classical Islamicate world. Further studies on this subjects are sorely needed, in light of the literary presence of this festival and its connection to fiscal matters, as a quick look to the present volume will make clear to the reader. Moreover, this is in agreement with all contemporary studies on the history of Iranian strands in Islamic pre-modern societies, which seldom fails to mention the need for a systematic study of literary evidence

Women’s Utilisation, Experiences and Satisfaction with Postnatal Follow-up Care: Systematic literature review

Postnatal follow-up care is reported to be the ‘underutilised’ aspect of the maternity care continuum. This review explores women’s utilisation of early and late postnatal follow-up and their experiences and satisfaction with it. Five online databases were searched for English or Arabic articles published between 2011 and 2021. Methodological quality of included studies was assessed using the Mixed Methods Appraisal Tool; the Andersen healthcare utilisation model was the framework for data analysis. A total of 19 articles met all inclusion criteria. Utilisation facilitators included complications, travel distance, knowledge of the importance for attending and being offered a telephonecall and home visit or clinic visit as options for follow-up. Impediments included lack of perceived need and notbeing provided with information about postnatal care. Comprehensive discussions with and examination by health providers were reported as positive experiences and influenced repeat utilisation. Dissatisfaction was associated with inconsistent information provided by health providers.Keywords: Postpartum Period; Postnatal Care; Women; Literature Review

Women’s Views on Factors that Influence Utilisation of Postnatal Follow-Up in Oman: A descriptive, qualitative study

Objective: Postnatal follow-up care (PNFC) is important to promote maternal and newborn health and wellbeing. In Oman, women’s utilisation of postnatal follow-up services has declined with rates as low as 0.29 (mean visits) in some Governorates; well below the recommended postnatal follow up visits at two- and six-weeks for assessment of mother and newborn. The reasons for low utilisation are not well understood. The aim of this study is to explore women’s views and identify factors that influence their utilisation of postnatal follow-up services. Methods: Purposive sampling and semi-structured telephone interviews with 15 women aged 20 to 39 years at six to eight weeks post childbirth between May 2021 to August 2022. Data were analysed using Erlingsson and Brysiewicz content analysis approach. Results: Six categories were identified as influencing PNFC utilisation: 1) need for information; 2) experiences and expectations; 3) family support, expectations and customs; 4) sociocultural beliefs and practice; 5) impact of Covid-19 and 6) the healthcare environment. Influencing factors within each category include the need to: empower women, provide individualised care, address family and community expectations, offer alternatives to face-to-face clinic visits, provide organised, scheduled appointments. Conclusion: Women in Oman identified the need for consistent information from health care providers (HCPs), a more organised postnatal follow-up service including scheduled appointments and a woman-centred approach to PNFC. Keywords: Postnatal care; postpartum period; qualitative research

Avian Rounds, Vol. 5, 1986

Topics in this issue of Avian Rounds include: Avian Anesthesia (Kathy Linn); The Effects of Diet and Calcium on Pet Bird Health (Richard Blomquist); A Case Report: Avian Tuberculosis in a Green-Cheeked Amazon Parrot (Shelby Riddle)

Toward Improving Physician/Patient Communication Regarding Invisible Chronic Illness (ICI): The Potential of mHealth Technology in Instructional Communication

Patients that suffer from invisible chronic illness (ICI) such as autoimmune conditions, neurological conditions, and gastrointestinal problems often struggle to obtain a proper medical diagnosis due to a lack of objective indicators to help health-care providers diagnose patients with ICIs. Thus, researchers conducted interviews with 21 participants with Postural Orthostatic Tachycardia Syndrome (POTS) to determine what messages they received from health-care providers as they pursued a diagnosis, how they interpreted those messages, and what role mHealth technology may play in improving patient/provider communication and effective diagnosis/treatment of ICIs. Several themes regarding potential instructional communication intervention content emerged from the interview data, including physician communication to patients, patient interpretation of physician communication, and information-seeking via mHealth technology. Directions for future research and implications for patient and provider instruction and training, including utilizing the IDEA model, are discussed

Clinically-indicated replacement versus routine replacement of peripheral venous catheters (Review)

Background: US Centers for Disease Control guidelines recommend replacement of peripheral intravenous (IV) catheters no more frequently than every 72 to 96 hours. Routine replacement is thought to reduce the risk of phlebitis and bloodstream infection. Catheter insertion is an unpleasant experience for patients and replacement may be unnecessary if the catheter remains functional and there are no signs of inflammation. Costs associated with routine replacement may be considerable. This is an update of a review first published in 2010. Objectives: To assess the effects of removing peripheral IV catheters when clinically indicated compared with removing and re-siting the catheter routinely. Search methods: For this update the Cochrane Vascular Trials Search Co-ordinator searched the Cochrane Vascular Specialised Register (March 2015) and CENTRAL (2015, Issue 3). We also searched clinical trials registries (April 2015). Selection criteria: Randomised controlled trials that compared routine removal of peripheral IV catheters with removal only when clinically indicated in hospitalised or community dwelling patients receiving continuous or intermittent infusions. Data collection and analysis: Two review authors independently assessed trial quality and extracted data. Main results: Seven trials with a total of 4895 patients were included in the review. The quality of the evidence was high for most outcomes but was downgraded to moderate for the outcome catheter-related bloodstream infection (CRBSI). The downgrade was due to wide confidence intervals, which created a high level of uncertainty around the effect estimate. CRBSI was assessed in five trials (4806 patients). There was no significant between group difference in the CRBSI rate (clinically-indicated 1/2365; routine change 2/2441). The risk ratio (RR) was 0.61 (95% CI 0.08 to 4.68; P = 0.64). No difference in phlebitis rates was found whether catheters were changed according to clinical indications or routinely (clinically-indicated 186/2365; 3-day change 166/2441; RR 1.14, 95% CI 0.93 to 1.39). This result was unaffected by whether infusion through the catheter was continuous or intermittent. We also analysed the data by number of device days and again no differences between groups were observed (RR 1.03, 95% CI 0.84 to 1.27; P = 0.75). One trial assessed all-cause bloodstream infection. There was no difference in this outcome between the two groups (clinically-indicated 4/1593 (0.02%); routine change 9/1690 (0.05%); P = 0.21). Cannulation costs were lower by approximately AUD 7.00 in the clinically-indicated group (mean difference (MD) -6.96, 95% CI -9.05 to -4.86; P ≤ 0.00001). Authors' conclusions: The review found no evidence to support changing catheters every 72 to 96 hours. Consequently, healthcare organisations may consider changing to a policy whereby catheters are changed only if clinically indicated. This would provide significant cost savings and would spare patients the unnecessary pain of routine re-sites in the absence of clinical indications. To minimise peripheral catheter-related complications, the insertion site should be inspected at each shift change and the catheter removed if signs of inflammation, infiltration, or blockage are present

Clinically-indicated replacement versus routine replacement of peripheral venous catheters [Review]

Background US Centers for Disease Control guidelines recommend replacement of peripheral intravenous (IV) catheters no more frequently than every 72 to 96 hours. Routine replacement is thought to reduce the risk of phlebitis and bloodstream infection. Catheter insertion is an unpleasant experience for patients and replacement may be unnecessary if the catheter remains functional and there are no signs of inflammation. Costs associated with routine replacement may be considerable. This is an update of a review first published in 2010. Objectives To assess the effects of removing peripheral IV catheters when clinically indicated compared with removing and re‐siting the catheter routinely. Search methods For this update the Cochrane Peripheral Vascular Diseases (PVD) Group Trials Search Co‐ordinator searched the PVD Specialised Register (December 2012) and CENTRAL (2012, Issue 11). We also searched MEDLINE (last searched October 2012) and clinical trials registries. Selection criteria Randomised controlled trials that compared routine removal of peripheral IV catheters with removal only when clinically indicated in hospitalised or community dwelling patients receiving continuous or intermittent infusions. Data collection and analysis Two review authors independently assessed trial quality and extracted data. Main results Seven trials with a total of 4895 patients were included in the review. Catheter‐related bloodstream infection (CRBSI) was assessed in five trials (4806 patients). There was no significant between group difference in the CRBSI rate (clinically‐indicated 1/2365; routine change 2/2441). The risk ratio (RR) was 0.61 but the confidence interval (CI) was wide, creating uncertainty around the estimate (95% CI 0.08 to 4.68; P = 0.64). No difference in phlebitis rates was found whether catheters were changed according to clinical indications or routinely (clinically‐indicated 186/2365; 3‐day change 166/2441; RR 1.14, 95% CI 0.93 to 1.39). This result was unaffected by whether infusion through the catheter was continuous or intermittent. We also analysed the data by number of device days and again no differences between groups were observed (RR 1.03, 95% CI 0.84 to 1.27; P = 0.75). One trial assessed all‐cause bloodstream infection. There was no difference in this outcome between the two groups (clinically‐indicated 4/1593 (0.02%); routine change 9/1690 (0.05%); P = 0.21). Cannulation costs were lower by approximately AUD 7.00 in the clinically‐indicated group (mean difference (MD) ‐6.96, 95% CI ‐9.05 to ‐4.86; P ≤ 0.00001). Authors' conclusions The review found no evidence to support changing catheters every 72 to 96 hours. Consequently, healthcare organisations may consider changing to a policy whereby catheters are changed only if clinically indicated. This would provide significant cost savings and would spare patients the unnecessary pain of routine re‐sites in the absence of clinical indications. To minimise peripheral catheter‐related complications, the insertion site should be inspected at each shift change and the catheter removed if signs of inflammation, infiltration, or blockage are present

Vitamin D Status of the British African-Caribbean Residents : Analysis of the UK Biobank Cohort

Funding: This work is part of the PhD of R.M.V., which is funded by the Universities Global Part‐ nership Network, co‐supervised by the Universities of Surrey and Wollongong. Funders did not have a role in the study. The researchers are independent to the funders. All authors take responsibility for the integrity of the data and the accuracy of the data analysis.Peer reviewedPublisher PD

Does Vitamin D play a role in the management of Covid-19 in Brazil?

The study discusses the possible role of adequate vitamin D status in plasma or serum for preventing acute respiratory infections during the Covid-19 pandemic. Our arguments respond to an article, published in Italy, that describes the high prevalence of hypovitaminosis D in older Italian women and raises the possible preventive and therapeutic role of optimal vitamin D levels. Based on literature review, we highlight the findings regarding the protective role of vitamin D for infectious diseases of the respiratory system. However, randomized controlled trials are currently lacking. Adequate vitamin D status is obtained from sun exposure and foods rich in vitamin D. Studies in Brazil have shown that hypovitaminosis D is quite common in spite of high insolation. Authors recommend ecological, epidemiological and randomized controlled trials studies to verify this hypothesis