No Evidence of Persisting Unrepaired Nuclear DNA Single Strand Breaks in Distinct Types of Cells in the Brain, Kidney, and Liver of Adult Mice after Continuous Eight-Week 50 Hz Magnetic Field Exposure with Flux Density of 0.1 mT or 1.0 mT

BACKGROUND: It has been hypothesized in the literature that exposure to extremely low frequency electromagnetic fields (50 or 60 Hz) may lead to human health effects such as childhood leukemia or brain tumors. In a previous study investigating multiple types of cells from brain and kidney of the mouse (Acta Neuropathologica 2004; 107: 257-264), we found increased unrepaired nuclear DNA single strand breaks (nDNA SSB) only in epithelial cells of the choroid plexus in the brain using autoradiographic methods after a continuous eight-week 50 Hz magnetic field (MF) exposure of adult mice with flux density of 1.5 mT. METHODS: In the present study we tested the hypothesis that MF exposure with lower flux densities (0.1 mT, i.e., the actual exposure limit for the population in most European countries, and 1.0 mT) shows similar results to those in the previous study. Experiments and data analysis were carried out in a similar way as in our previous study. RESULTS: Continuous eight-week 50 Hz MF exposure with 0.1 mT or 1.0 mT did not result in increased persisting unrepaired nDNA SSB in distinct types of cells in the brain, kidney, and liver of adult mice. MF exposure with 1.0 mT led to reduced unscheduled DNA synthesis (UDS) in epithelial cells in the choroid plexus of the fourth ventricle in the brain (EC-CP) and epithelial cells of the cortical collecting duct in the kidney, as well as to reduced mtDNA synthesis in neurons of the caudate nucleus in the brain and in EC-CP. CONCLUSION: No evidence was found for increased persisting unrepaired nDNA SSB in distinct types of cells in the brain, kidney, and liver of adult mice after continuous eight-week 50 Hz magnetic field exposure with flux density of 0.1 mT or 1.0 mT

Global, regional, and national burden of colorectal cancer and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Funding: F Carvalho and E Fernandes acknowledge support from Fundação para a Ciência e a Tecnologia, I.P. (FCT), in the scope of the project UIDP/04378/2020 and UIDB/04378/2020 of the Research Unit on Applied Molecular Biosciences UCIBIO and the project LA/P/0140/2020 of the Associate Laboratory Institute for Health and Bioeconomy i4HB; FCT/MCTES through the project UIDB/50006/2020. J Conde acknowledges the European Research Council Starting Grant (ERC-StG-2019-848325). V M Costa acknowledges the grant SFRH/BHD/110001/2015, received by Portuguese national funds through Fundação para a Ciência e Tecnologia (FCT), IP, under the Norma Transitória DL57/2016/CP1334/CT0006.proofepub_ahead_of_prin

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic

Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021

Background: Future trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) and provide a reference forecast (the most likely future), and alternative scenarios assessing disease burden trajectories if selected sets of risk factors were eliminated from current levels by 2050. Methods: Using forecasts of major drivers of health such as the Socio-demographic Index (SDI; a composite measure of lag-distributed income per capita, mean years of education, and total fertility under 25 years of age) and the full set of risk factor exposures captured by GBD, we provide cause-specific forecasts of mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) by age and sex from 2022 to 2050 for 204 countries and territories, 21 GBD regions, seven super-regions, and the world. All analyses were done at the cause-specific level so that only risk factors deemed causal by the GBD comparative risk assessment influenced future trajectories of mortality for each disease. Cause-specific mortality was modelled using mixed-effects models with SDI and time as the main covariates, and the combined impact of causal risk factors as an offset in the model. At the all-cause mortality level, we captured unexplained variation by modelling residuals with an autoregressive integrated moving average model with drift attenuation. These all-cause forecasts constrained the cause-specific forecasts at successively deeper levels of the GBD cause hierarchy using cascading mortality models, thus ensuring a robust estimate of cause-specific mortality. For non-fatal measures (eg, low back pain), incidence and prevalence were forecasted from mixed-effects models with SDI as the main covariate, and YLDs were computed from the resulting prevalence forecasts and average disability weights from GBD. Alternative future scenarios were constructed by replacing appropriate reference trajectories for risk factors with hypothetical trajectories of gradual elimination of risk factor exposure from current levels to 2050. The scenarios were constructed from various sets of risk factors: environmental risks (Safer Environment scenario), risks associated with communicable, maternal, neonatal, and nutritional diseases (CMNNs; Improved Childhood Nutrition and Vaccination scenario), risks associated with major non-communicable diseases (NCDs; Improved Behavioural and Metabolic Risks scenario), and the combined effects of these three scenarios. Using the Shared Socioeconomic Pathways climate scenarios SSP2-4.5 as reference and SSP1-1.9 as an optimistic alternative in the Safer Environment scenario, we accounted for climate change impact on health by using the most recent Intergovernmental Panel on Climate Change temperature forecasts and published trajectories of ambient air pollution for the same two scenarios. Life expectancy and healthy life expectancy were computed using standard methods. The forecasting framework includes computing the age-sex-specific future population for each location and separately for each scenario. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. Findings: In the reference scenario forecast, global and super-regional life expectancy increased from 2022 to 2050, but improvement was at a slower pace than in the three decades preceding the COVID-19 pandemic (beginning in 2020). Gains in future life expectancy were forecasted to be greatest in super-regions with comparatively low life expectancies (such as sub-Saharan Africa) compared with super-regions with higher life expectancies (such as the high-income super-region), leading to a trend towards convergence in life expectancy across locations between now and 2050. At the super-region level, forecasted healthy life expectancy patterns were similar to those of life expectancies. Forecasts for the reference scenario found that health will improve in the coming decades, with all-cause age-standardised DALY rates decreasing in every GBD super-region. The total DALY burden measured in counts, however, will increase in every super-region, largely a function of population ageing and growth. We also forecasted that both DALY counts and age-standardised DALY rates will continue to shift from CMNNs to NCDs, with the most pronounced shifts occurring in sub-Saharan Africa (60·1% [95% UI 56·8–63·1] of DALYs were from CMNNs in 2022 compared with 35·8% [31·0–45·0] in 2050) and south Asia (31·7% [29·2–34·1] to 15·5% [13·7–17·5]). This shift is reflected in the leading global causes of DALYs, with the top four causes in 2050 being ischaemic heart disease, stroke, diabetes, and chronic obstructive pulmonary disease, compared with 2022, with ischaemic heart disease, neonatal disorders, stroke, and lower respiratory infections at the top. The global proportion of DALYs due to YLDs likewise increased from 33·8% (27·4–40·3) to 41·1% (33·9–48·1) from 2022 to 2050, demonstrating an important shift in overall disease burden towards morbidity and away from premature death. The largest shift of this kind was forecasted for sub-Saharan Africa, from 20·1% (15·6–25·3) of DALYs due to YLDs in 2022 to 35·6% (26·5–43·0) in 2050. In the assessment of alternative future scenarios, the combined effects of the scenarios (Safer Environment, Improved Childhood Nutrition and Vaccination, and Improved Behavioural and Metabolic Risks scenarios) demonstrated an important decrease in the global burden of DALYs in 2050 of 15·4% (13·5–17·5) compared with the reference scenario, with decreases across super-regions ranging from 10·4% (9·7–11·3) in the high-income super-region to 23·9% (20·7–27·3) in north Africa and the Middle East. The Safer Environment scenario had its largest decrease in sub-Saharan Africa (5·2% [3·5–6·8]), the Improved Behavioural and Metabolic Risks scenario in north Africa and the Middle East (23·2% [20·2–26·5]), and the Improved Nutrition and Vaccination scenario in sub-Saharan Africa (2·0% [–0·6 to 3·6]). Interpretation: Globally, life expectancy and age-standardised disease burden were forecasted to improve between 2022 and 2050, with the majority of the burden continuing to shift from CMNNs to NCDs. That said, continued progress on reducing the CMNN disease burden will be dependent on maintaining investment in and policy emphasis on CMNN disease prevention and treatment. Mostly due to growth and ageing of populations, the number of deaths and DALYs due to all causes combined will generally increase. By constructing alternative future scenarios wherein certain risk exposures are eliminated by 2050, we have shown that opportunities exist to substantially improve health outcomes in the future through concerted efforts to prevent exposure to well established risk factors and to expand access to key health interventions

Autoradiographische Modelluntersuchungen an der Maus zum Einfluss einer achtwöchigen 50-Hz-Magnetfeld-Exposition auf DNA-Reparatur und mitochondriale DNA-Synthese von Tubulusepithelzellen der Niere

1.) The aim of this study was to use autoradiographic analyses after the injection of 3H-thymidine (TdR) to investigate the nuclear DNA repair synthesis rate ("unscheduled DNA synthesis" = UDS) and the mitochondrial DNA synthesis rate of proximal and distal tubular epithelium cells in the kidney of the 9-month-old mouse after an eight-week exposure to a magnetic field (MF) of varying intensity.2.) Out of a total of 80 test animals, 29 animals were exposed to a magnetic field at 50 Hz with a mean magnetic flux density of 1 mT or 0.1 mT respectively, while 15 animals were subjected to a control exposure (0 mT). The remaining seven inactive animals, which had neither been exposed to a magnetic field nor injected with 3H-thymidine, were used for control of background labelling. The animals exposed to a magnetic field were injected 5 minutes (in Group A) or 24 hours (Group B) or 7 days (Group C) with 555 kBq 3H-thymidine per gram of body weight after the end of the MF-exposure. Two hours later, they were sacrificed, some organs (e. g. kidney) removed and preserved with a fixative for several weeks. Subsequently, 3 µm thick paraffin sections were prepared, Feulgen stained, and finally, after an exposure of 250 days, autoradiograms were produced, which were examined under the microscope at a 1250x primary magnification. 100 consecutive cells per cell type were analyzed with regard to the number of nuclear grain number or cytoplasmic grain number inclusive the corresponding profile areas of the cells. By correcting for the background labelling, normalization the mean nuclear grain numbers concerning the diploid DNA content of the section volume, standardizing the nucleus marker to a uniform DNA quantity per segment volume or calculating cytoplasmic silver grain densities, respectively, a direct comparison of the labelling of different cell types was possible.3.) The possible autoradiographic artifacts as well as animal specific effects were detected by studying cumulative frequency distributions of the grain counts. The data of the different groups were compared by univariance analysis and post-hoc t-tests with consideration of a Bonferroni correction. All probabilities with p<0.05 were considered statistically significant. Finally, linear regression analyses were used to determine whether dose-dependent effects exist.4.) In relation to the UDS, the univariance analyses did not show any significant results either in the proximal nor distal tubulus. However, when the data from the earlier investigations performed by Keller (2003) and Freuding (2004) with the same methodology for a magnetic field exposure of 1.5 mT were included, the linear regression analysis resulted in a UDS which increased significantly with the dose, but only for the tubular epithelial cells of the proximal tubulus. This is fully consistent with earlier findings of Keller (2003), but not with those of Freuding (2004). However, the univariance analyses for nuclear profile areas and also for cytoplasmic silver grain densities showed no statistical significances. 5.) Regarding the influence of the time of the 3H-thymidine injection on the UDS, no statistical significances were found in the univariance analyses. However, with regard to the cytoplasmic silver grain density, a significant result was found for both the proximal and distal tubular epithelial cells, although this result could not be confirmed in the subsequent post-hoc t-tests.6.) With regard to the relative range of the measured values achieved here, a clear increase occurred in comparison to Keller (2003) and Freuding (2004); however, no correlations with the magnetic field intensity could be detected. These large ranges were possibly responsible for the fact that no significant results were achieved.7.)Summarizing the findings of previous studies concerning MF-induced DNA damage in the kidney, it is apparent that damage to the nuclear DNA is to be expected after magnetic field exposure at 50 Hz. However, such damage should be repaired, directly after it occurs

Autoradiographische Modelluntersuchungen an der Maus zum Einfluss einer achtwöchigen 50-Hz-Magnetfeld-Exposition auf DNA-Reparatur und mitochondriale DNA-Synthese von Tubulusepithelzellen der Niere

1.) The aim of this study was to use autoradiographic analyses after the injection of 3H-thymidine (TdR) to investigate the nuclear DNA repair synthesis rate ("unscheduled DNA synthesis" = UDS) and the mitochondrial DNA synthesis rate of proximal and distal tubular epithelium cells in the kidney of the 9-month-old mouse after an eight-week exposure to a magnetic field (MF) of varying intensity.2.) Out of a total of 80 test animals, 29 animals were exposed to a magnetic field at 50 Hz with a mean magnetic flux density of 1 mT or 0.1 mT respectively, while 15 animals were subjected to a control exposure (0 mT). The remaining seven inactive animals, which had neither been exposed to a magnetic field nor injected with 3H-thymidine, were used for control of background labelling. The animals exposed to a magnetic field were injected 5 minutes (in Group A) or 24 hours (Group B) or 7 days (Group C) with 555 kBq 3H-thymidine per gram of body weight after the end of the MF-exposure. Two hours later, they were sacrificed, some organs (e. g. kidney) removed and preserved with a fixative for several weeks. Subsequently, 3 µm thick paraffin sections were prepared, Feulgen stained, and finally, after an exposure of 250 days, autoradiograms were produced, which were examined under the microscope at a 1250x primary magnification. 100 consecutive cells per cell type were analyzed with regard to the number of nuclear grain number or cytoplasmic grain number inclusive the corresponding profile areas of the cells. By correcting for the background labelling, normalization the mean nuclear grain numbers concerning the diploid DNA content of the section volume, standardizing the nucleus marker to a uniform DNA quantity per segment volume or calculating cytoplasmic silver grain densities, respectively, a direct comparison of the labelling of different cell types was possible.3.) The possible autoradiographic artifacts as well as animal specific effects were detected by studying cumulative frequency distributions of the grain counts. The data of the different groups were compared by univariance analysis and post-hoc t-tests with consideration of a Bonferroni correction. All probabilities with p<0.05 were considered statistically significant. Finally, linear regression analyses were used to determine whether dose-dependent effects exist.4.) In relation to the UDS, the univariance analyses did not show any significant results either in the proximal nor distal tubulus. However, when the data from the earlier investigations performed by Keller (2003) and Freuding (2004) with the same methodology for a magnetic field exposure of 1.5 mT were included, the linear regression analysis resulted in a UDS which increased significantly with the dose, but only for the tubular epithelial cells of the proximal tubulus. This is fully consistent with earlier findings of Keller (2003), but not with those of Freuding (2004). However, the univariance analyses for nuclear profile areas and also for cytoplasmic silver grain densities showed no statistical significances. 5.) Regarding the influence of the time of the 3H-thymidine injection on the UDS, no statistical significances were found in the univariance analyses. However, with regard to the cytoplasmic silver grain density, a significant result was found for both the proximal and distal tubular epithelial cells, although this result could not be confirmed in the subsequent post-hoc t-tests.6.) With regard to the relative range of the measured values achieved here, a clear increase occurred in comparison to Keller (2003) and Freuding (2004); however, no correlations with the magnetic field intensity could be detected. These large ranges were possibly responsible for the fact that no significant results were achieved.7.)Summarizing the findings of previous studies concerning MF-induced DNA damage in the kidney, it is apparent that damage to the nuclear DNA is to be expected after magnetic field exposure at 50 Hz. However, such damage should be repaired, directly after it occurs

Sjuksköterskors Upplevelser Av Att Vårda Patienter I Livets Slutskede : En Litteraturstudie

Bakgrund: Patienter som vårdas i livets slutskede önskar en god vård av sjuksköterskor samt en god sista tid. De upplever en förlust av autonomi och självbestämmande och de önskar ett respektfullt bemötande. Patienter anser att otillräckligt stöd från sjuksköterskorna bidrar till orolighet och ångest under sista tiden i livet. Anhöriga till patienter anser att de har ett stort behov av stöd, en god kommunikation och tillräcklig information. De anhöriga upplever inte alltid att detta behov tillfredsställs. Syftet: Beskriva sjuksköterskors upplevelse av att vårda patienter i livets slutskede. Metod: En litteraturstudie med beskrivande syntes baserad på 11 kvalitativa artiklar. Resultat: I resultatet framkom två teman med fyra subteman. Det första huvudtemat Göra gott för den unika människan uppmärksammar sjuksköterskors upplevelser av vikten att tillfredsställa patienters behov och att skapa goda relationer. I det andra huvudtemat, Hinder i vårdandet, beskrevs två hinder som sjuksköteskor upplevde, svårighet i kommunikation och brist på kunskap och erfarenhet. Slutsats: Sjusköterskorna upplevde att vården var berikande när de kinde skapa goda relationer med patienter och anhöriga och tillgodose deras behov. Dock upplevde sjuksköterskorna att vården innebar utmaningar som var relaterade till bristande kunskap och erfarenhet vilket kunde utgöra ett hinder till tillfredställa patienternas behov. Background: Patients who are cared for at the end of life want good care by nurses and good last days of life. They experience a loss of autonomy and self-determination and they want a respectful treatment. Patients believe that insufficient support from the nurses contributes to anxiety and anxiety in palliative care. Relatives of patients believe that they have a great need for support, good communication and sufficient information. The relatives do not always feel that this need is met. Aim: The aim of the examination work is to describe nurses experience of caring for patients at the final stages of life. Method: A literature study with descriptive synthesis based on 11 qualitative articles. Results: The results revealed two themes with four subthemes. The first main theme Do good for the unique person draws attention to nurses' experiences of the importance of satisfying patients' needs and creating good relationships. The second main theme, Obstacles in care, described two obstacles that nurses experienced, difficulties in communication and lack of knowledge and experience. Conclusion: The nurses felt that the care was enriching when they could create good relationships with patients and relatives and meet their needs. However, the nurses experienced the care involved challenges that were related to lack of knowledge and experience, which could constitute an obstacle to satisfying the patients' needs.

Prediction of psychological strain based on perceived work difficulty, occupational hardiness and spirituality among nurses working in hospitals of Malayer

Introduction: Nurses as the major group of health service providers need to have the satisfactory mental health in order to give desirably care for the patients. Therefore this study was done aimed to predict of psychological strain based on perceived work difficulty, occupational hardiness and spirituality among nurses working in hospitals of Malayer. Methods: The research was descriptive and from correlation type. The statistical population included all nurses working in hospitals of Malayer in 2016 year that 115 people were selected using convenience sampling method. Psychological Strain Questionnaire (PSQ), Work Difficultly Scale, Occupational Hardiness Questionnaire (OHQ) and Daily Spiritual Experience Scale (DSES) were used for gathering data. Pearson correlation, multivariate stepwise regression and software SPSS-22 were used for analyzing the data. Results: The results showed that there was a significant correlation between perceived work difficulty, component of challenge from occupational hardiness and spirituality with psychological strain (p<0/01), but there wasn't a significant correlation between components of control and commitment from occupational hardiness with psychological strain. Also inter regression analysis results showed that perceived work difficulty, component of commitment from occupational hardiness and spirituality can explain totally %59/7 of psychological strain variance, but components of control and challenge from occupational hardiness cannot predict psychological strain. Conclusion: According to findings of this study, can suggested training and intervention on improving perceived work difficulty, component of commitment from occupational hardiness and spirituality of nurses as an effective way on decreasing their psychological strain

A robust optimization model for a decision-making problem: An application for stock market

In this paper we apply robust linear programming technique for multidimensional analysis of preference (LINMAP) method for a decision making problem. During the last two decades, many methods have been extensively used for decision making problems. However, there is no investigation among many existing studies where the uncertainty in data is possible. The robust LINMAP method with the assumption of uncertainty on parameters is implemented in the stock market in order to rank priorities of the stocks. Keywords: Decision making, Robust LINMAP, Stoc

Methicillin Resistant Staphylococcus Aureus in Ventilator Associated Pneumonia in Toxicological Intensive Care Unit

Background: Methicillin resistant Staphylococus Aureus (MRSA) is a cause of nosocomial infections at intensive care unit (ICU), which imposes a high mortality and morbidity on the health care systems. The objective of this study was to evaluate the role of MRSA in patients with clinically suspected ventilator associated pneumonia (VAP) in toxicological ICU admitted patients. Methods: This cross-sectional study was performed over a period of six months from August 2009 to February 2010. A total of 84 patients with clinically suspected VAP were selected from all 381 ICU admitted patients under mechanical ventilation for more than 48 hours. MRSA Screen Agar was used to detect resistance in Staph aureus specimens. MRSA was determined as the main outcome. Results: MRSA was the cause in 54% of Staph aureus infected VAPs. Although MRSA infection was not significantly associated with age, gender, cause of poisoning, chronic disease, paraclinical findings, length of hospital stay, and antibiotic prescription (P>0.05 for all comparisons), it was reported higher in those who expired than those who survived (66.7% vs. 31.9%, P<0.012). Conclusion: In the main referral toxicological ICU in Tehran, in more than 1 of 3 clinically suspected VAP cases, MRSA was seen which was associated with the poorer outcome, higher inpatient mortality