Interactive Effects of Climate Change with Nutrients, Mercury, and Freshwater Acidification on Key Taxa in the North Atlantic Landscape Conservation Cooperative Region

The North Atlantic Landscape Conservation Cooperative LCC (NA LCC) is a public-private partnership that provides information to support conservation decisions that may be affected by global climate change (GCC) and other threats. The NA LCC region extends from southeast Virginia to the Canadian Maritime Provinces. Within this region, the US National Climate Assessment documented increases in air temperature, total precipitation, frequency of heavy precipitation events, and rising sea level, and predicted more drastic changes. Here, we synthesize literature on the effects of GCC interacting with selected contaminant, nutrient, and environmental processes to adversely affect natural resources within this region. Using a case study approach, we focused on 3 stressors with sufficient NA LCC region-specific information for an informed discussion. We describe GCC interactions with a contaminant (Hg) and 2 complex environmental phenomena-freshwater acidification and eutrophication. We also prepared taxa case studies on GCC- and GCC-contaminant/nutrient/process effects on amphibians and freshwater mussels. Several avian species of high conservation concern have blood Hg concentrations that have been associated with reduced nesting success. Freshwater acidification has adversely affected terrestrial and aquatic ecosystems in the Adirondacks and other areas of the region that are slowly recovering due to decreased emissions of N and sulfur oxides. Eutrophication in many estuaries within the region is projected to increase from greater storm runoff and less denitrification in riparian wetlands. Estuarine hypoxia may be exacerbated by increased stratification. Elevated water temperature favors algal species that produce harmful algal blooms (HABs). In several of the region\u27s estuaries, HABs have been associated with bird die-offs. In the NA LCC region, amphibian populations appear to be declining. Some species may be adversely affected by GCC through higher temperatures and more frequent droughts. GCC may affect freshwater mussel populations via altered stream temperatures and increased sediment loading during heavy storms. Freshwater mussels are sensitive to un-ionized ammonia that more toxic at higher temperatures. We recommend studying the interactive effects of GCC on generation and bioavailability of methylmercury and how GCC-driven shifts in bird species distributions will affect avian exposure to methylmercury. Research is needed on how decreases in acid deposition concurrent with GCC will alter the structure and function of sensitive watersheds and surface waters. Studies are needed to determine how GCC will affect HABs and avian disease, and how more severe and extensive hypoxia will affect fish and shellfish populations. Regarding amphibians, we suggest research on 1) thermal tolerance and moisture requirements of species of concern, 2) effects of multiple stressors (temperature, desiccation, contaminants, nutrients), and 3) approaches to mitigate impacts of increased temperature and seasonal drought. We recommend studies to assess which mussel species and populations are vulnerable and which are resilient to rising stream temperatures, hydrological shifts, and ionic pollutants, all of which are influenced by GCC

Classification of paediatric brain tumours by diffusion weighted imaging and machine learning

To determine if apparent diffusion coefficients (ADC) can discriminate between posterior fossa brain tumours on a multicentre basis. A total of 124 paediatric patients with posterior fossa tumours (including 55 Medulloblastomas, 36 Pilocytic Astrocytomas and 26 Ependymomas) were scanned using diffusion weighted imaging across 12 different hospitals using a total of 18 different scanners. Apparent diffusion coefficient maps were produced and histogram data was extracted from tumour regions of interest. Total histograms and histogram metrics (mean, variance, skew, kurtosis and 10th, 20th and 50th quantiles) were used as data input for classifiers with accuracy determined by tenfold cross validation. Mean ADC values from the tumour regions of interest differed between tumour types, (ANOVA P < 0.001). A cut off value for mean ADC between Ependymomas and Medulloblastomas was found to be of 0.984 × 10-3 mm2 s-1 with sensitivity 80.8% and specificity 80.0%. Overall classification for the ADC histogram metrics were 85% using Naïve Bayes and 84% for Random Forest classifiers. The most commonly occurring posterior fossa paediatric brain tumours can be classified using Apparent Diffusion Coefficient histogram values to a high accuracy on a multicentre basis

The management of diabetic ketoacidosis in children

The object of this review is to provide the definitions, frequency, risk factors, pathophysiology, diagnostic considerations, and management recommendations for diabetic ketoacidosis (DKA) in children and adolescents, and to convey current knowledge of the causes of permanent disability or mortality from complications of DKA or its management, particularly the most common complication, cerebral edema (CE). DKA frequency at the time of diagnosis of pediatric diabetes is 10%–70%, varying with the availability of healthcare and the incidence of type 1 diabetes (T1D) in the community. Recurrent DKA rates are also dependent on medical services and socioeconomic circumstances. Management should be in centers with experience and where vital signs, neurologic status, and biochemistry can be monitored with sufficient frequency to prevent complications or, in the case of CE, to intervene rapidly with mannitol or hypertonic saline infusion. Fluid infusion should precede insulin administration (0.1 U/kg/h) by 1–2 hours; an initial bolus of 10–20 mL/kg 0.9% saline is followed by 0.45% saline calculated to supply maintenance and replace 5%–10% dehydration. Potassium (K) must be replaced early and sufficiently. Bicarbonate administration is contraindicated. The prevention of DKA at onset of diabetes requires an informed community and high index of suspicion; prevention of recurrent DKA, which is almost always due to insulin omission, necessitates a committed team effort

Relatório de estágio em farmácia comunitária

Relatório de estágio realizado no âmbito do Mestrado Integrado em Ciências Farmacêuticas, apresentado à Faculdade de Farmácia da Universidade de Coimbr

Rick A. Martínez Oral History Interview

Born in Santa Fe NM, Rick Martinez’ first job was as a mortician at the Berardinelli Funeral Home. After a few years, Martinez left that job to start working with his father and brothers in a family painting business where they developed contracts at various commercial businesses and with many residences in Santa Fe NM. The painting business lasted for over 20 years and then Martinez found his real work in neighborhood protection, preservation and appropriate development in the City of Santa Fe. Martinez has promoted community input in strengthening neighborhoods in Santa Fe City Council forums. He has been vigilant to monitor zoning designations and affordable housing set asides as well as to facilitate neighborhood participation in growth and development. One of his proudest achievements is the creation of the caboose landmark at the corner of St. Francis and Cerrillos Roads.https://digitalrepository.unm.edu/wphnm/1052/thumbnail.jp

ПРЕКЛІНІЧНІ ДОСЛІДЖЕННЯ ЗНЕБОЛЮЮЧОЇ ТА ПРОТИПРОНОСНОЇ ДІЇ ELAEOCARPUS SERRATUS L. НА МИШАХ

Background. Elaeocarpus serratus L. (Family: Elaeocarpaceae) is a tropical fruit tree, traditionally used in the treatments of poisoning, diarrhea, arthritis, and other diseases. Objectives. The current study was performed to conduct the analgesic, antidiarrheal, and hypoglycemic activity of E. serratus in mice model using methanolic bark crude extract. Methods. To assess the peripheral and central analgesic activity, the acetic acid-induced writhing and tail immersion methods were respectively used. The castor-oil mediated antidiarrheal method was used to assess the antidiarrheal activity whereas, the tail tipping technique was conducted to determine the hypoglycemic activity of the plant extract. Results. In the peripheral analgesic assay, the methanolic bark crude extract of E. serratus significantly inhibits the number of writing 69.77% (200 mg/kg) and 73.26% (400 mg/kg) respectively (p&lt;0.05) which was strongly comparable with standard NSAID drug diclofenac sodium 75.58% (p&lt;0.05). Similarly, it shown a significant tail flicking response for 30 minutes, 60 minutes and 90 minutes of central analgesic activity assay. In antidiarrheal activity assay, the E. serratus substantially reduced the number of diarrheal feces 64.26% (200 mg/kg, p&lt;0.05) and 78.57% (400 mg/kg, p&lt;0.05) which was also comparable with the positive control loperamide. The hypoglycemic activity of E. serratus extract was not convincing. Conclusions. Our investigation demonstrated the significant analgesic and antidiarrheal activities of methanolic bark extract of E. serratus (200 and 400 mg/kg) in mice model.Вступ. Elaeocarpus serratus L. (родина Elaeocarpaceae) - тропічне плодове дерево, фрукти, кора та інші частини якого традиційно використовуються при лікуванні отруєнь, діареї, артриту та інших захворювань. Мета – дослідити фармакологічну активність (знеболювальну, протидіарейну та гіпоглікемічну дію) сухого метанольного екстракту кори E. serratus на мишах. Методи. Для експериментальної оцінки центрального та периферичного компонентів у механізмі знеболювальної дії екстракту використовували метод оцінки больової реакції, що викликається хімічним подразненням – метод «оцтовокислих корчів», та метод теплового подразнення, суть якого полягає в зануренні хвоста миші у гарячу воду (55±0.5°C). Для оцінки протипроносної активності використовували модель діареї, викликаної введенням рициновою олією, для визначення гіпоглікемічної активності екстракту використали метод Durschlag et al., 1996, забір крові проводили шляхом надрізів хвоста. Результати. Встановлено, що застосування сухого метанольного екстракту кори E. serratus достовірно зменшує частоту розвитку корчів на 69,77% (200 мг/кг) та 73,26% (400 мг/кг) відповідно (p&lt;0,05), що досягає рівня активності стандартного НПЗП диклофенаку натрію, який зменшує показник на 75,58% (p&lt;0.05). Такі ж результати щодо частоти реакції хвоста піддослідних тварин протягом 30, 60 та 90 хвилин – показника центральної знеболюючої активності екстракту. Щодо протипроносної активності, то E. Serratus зменшував частоту діареї на 64.26% (200 мг/кг, p&lt;0,05) та 78,57% (400 мг/кг, p&lt;0,05), що також досягало також ж ефективності, які і у групі позитивного контролю з лоперамідом. Щодо гіпоглікемічної активності екстракту E. serratus – отримані нами результати були непере­конливими. Висновок. Наше дослідження продемонструвало значну знеболювальну та протидіарейну активність сухого метанольного екстракту кори E. serratus (200 та 400 мг/кг) на мишах

The ethanol extract of Euphorbia hirta exhibits in vitro antidiabetic potentials by sensitization of the insulin

The objective of current investigation was to assess the mechanism of action of Euphorbia hirta for its antidiabetic properties. Materials &amp;Methods: The authenticated leaves of plant Euphorbia hirta were dried and powdered. The powdered drug was defatted with petroleum ether and subjected to ethanol extraction. The ethanol extract of Euphorbia hirta was subjected to preliminary phytochemical investigation. The glucose up takes by rat hemi-diaphragm (skeletal muscle) model was also used evaluate potentials of the ethanol extract of Euphorbia hirta to enhance utilization of the blood glucose by peripheral tissues. The overnight fasted albino rat was sacrificed and dissected to hemidiaphragm. Weighed quantity of skeletal muscle was incubated with glucose in Tyrode solution for 30 mins at 37oC and the amount of glucose utilized by the tissue was determined. Results: The ethanol extract of Euphorbia hirta significantly increased the glucose utilization by skeletal muscle which its shows potency to sensitize the insulin. Conclusion: The results of the presents investigation recommends that, one of the mechanisms of ethanol extract of Euphorbia hirta for antidiabetic activity is reduction of insulin resistance

Bariatric surgery in patients with Type 2 diabetes: benefits, risks, indications and perspectives.

Obesity plays a key role in the pathophysiology of type 2 diabetes (T2DM), and weight loss is a major objective, although difficult to achieve with medical treatments. Bariatric surgery has proven its efficacy in obtaining marked and sustained weight loss, and is also associated with a significant improvement in glucose control and even diabetes remission. Roux-en-Y gastric bypass appears to be more effective in diabetic patients than the restrictive gastroplasty procedure. This may be explained not only by greater weight reduction, but also by specific hormonal changes. Indeed, increased levels of glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) may lead to improved beta-cell function and insulin secretion as well as reduced insulin resistance associated with weight loss. The presence of T2DM in obese individuals is a further argument to propose bariatric surgery, and even more so when diabetes is difficult to manage by medical means and other weight-related complications may occur. Bariatric surgery is associated with a better cardiovascular prognosis and reduced mortality, even though acute and long-term complications are present. The observation that surgical rerouting of nutrients triggers changes in the release of incretin hormones that, in turn, ameliorate the diabetic state in the absence of weight loss has led to the recent development of innovative surgical procedures. Thus, bariatric surgery may be said to be progressing towards so-called 'metabolic surgery', which merits further evaluation in patients with T2DM within a multidisciplinary approach that involves both surgeons and endocrinologists

Diagnostic accuracy and added value of qualitative radiological review of H-magnetic resonance spectroscopy in evaluation of childhood brain tumors.

Background H-magnetic resonance spectroscopy (MRS) facilitates noninvasive diagnosis of pediatric brain tumors by providing metabolite profiles. Prospective studies of diagnostic accuracy and comparisons with conventional MRI are lacking. We aimed to evaluate diagnostic accuracy of MRS for childhood brain tumors and determine added clinical value compared with conventional MRI. Methods Children presenting to a tertiary pediatric center with brain lesions from December 2015 through 2017 were included. MRI and single-voxel MRS were acquired on 52 tumors and sequentially interpreted by 3 radiologists, blinded to histopathology. Proportions of correct diagnoses and interrater agreement at each stage were compared. Cases were reviewed to determine added value of qualitative radiological review of MRS through increased certainty of correct diagnosis, reduced number of differentials, or diagnosis following spectroscopist evaluation. Final diagnosis was agreed by the tumor board at study end. Results Radiologists' principal MRI diagnosis was correct in 69%, increasing to 77% with MRS. MRI + MRS resulted in significantly more additional correct diagnoses than MRI alone ( = .035). There was a significant increase in interrater agreement when correct with MRS ( = .046). Added value following radiologist interpretation of MRS occurred in 73% of cases, increasing to 83% with additional spectroscopist review. First histopathological diagnosis was available a median of 9.5 days following imaging, with 25% of all patients managed without conclusive histopathology. Conclusions MRS can improve the accuracy of noninvasive diagnosis of pediatric brain tumors and add value in the diagnostic pathway. Incorporation into practice has the potential to facilitate early diagnosis, guide treatment planning, and improve patient care