A Core Outcome Set for nutritional intervention studies in older adults with malnutrition and those at risk: a study protocol

BACKGROUND: Malnutrition (i.e., protein-energy malnutrition) in older adults has severe negative clinical consequences, emphasizing the need for effective treatments. Many, often small, randomized controlled trials (RCTs) testing the effectiveness of nutritional interventions for the treatment of malnutrition showed mixed results and a need for meta-analyses and data pooling has been expressed. However, evidence synthesis is hampered by the wide variety of outcomes and their method of assessment in previous RCTs. This paper describes the protocol for developing a Core Outcome Set (COS) for nutritional intervention studies in older adults with malnutrition and those at risk. METHODS: The project consists of five phases. The first phase consists of a scoping review to identify frequently used outcomes in published RCTs and select additional patient-reported outcomes. The second phase includes a modified Delphi Survey involving experienced researchers and health care professionals working in the field of malnutrition in older adults, followed by the third phase consisting of a consensus meeting to discuss and agree what critical outcomes need to be included in the COS. The fourth phase will determine how each COS outcome should be measured based on a systematic literature review and a second consensus meeting. This will be followed by a dissemination and implementation phase. Patient and Public Involvement (PPI) representatives will contribute to study design, oversight, consensus, and dissemination. CONCLUSIONS: The result of this project is a COS that should be included in any RCT evaluating the effect of nutritional interventions in older adults with malnutrition and those at risk. This COS will facilitate comparison of RCT results, will increase efficient use of research resources and will reduce bias due to measurement of the outcome and publication bias. Ultimately, the COS will support clinical decision making by identifying the most effective approaches for treating and preventing malnutrition in older adults

Effect of octreotide on oxidative stress in the erythrocyte and kidney tissue in adriamycin-induced experimental nephrotic syndrome model

Abstract Introduction: Nephrotic syndrome (NS) is one of the reasons of end-stage kidney disease, and elucidating the pathogenesis and offer new treatment options is important. Oxidative stress might trigger pathogenesis systemically or isolated in the kidneys. Octreotide (OCT) has beneficial antioxidant effects. We aimed to investigate the source of oxidative stress and the effect of OCT on experimental NS model. Methods: Twenty-four non-uremic Wistar albino rats were divided into 3 groups. Control group, 2 mL saline intramuscular (im); NS group, adriamycin 5 mg/kg intravenous (iv); NS treatment group, adriamycin 5 mg/kg (iv) and OCT 200 mcg/kg (im) were administered at baseline (Day 0). At the end of 21 days, creatinine and protein levels were measured in 24-hour urine samples. Erythrocyte and renal catalase (CAT) and thiobarbituric acid reactive substance (TBARS) were measured. Renal histology was also evaluated. Results: There was no significant difference among the 3 groups in terms of CAT and TBARS in erythrocytes. Renal CAT level was lowest in NS group, and significantly lower than the control group. In treatment group, CAT level significantly increased compared with NS group. In terms of renal histology, tubular and interstitial evaluations were similar in all groups. Glomerular score was significantly higher in NS group compared with control group and it was significantly decreased in treatment group compared to NS group. Conclusions: Oxidative stress in NS might be due to the decrease in antioxidant protection mechanism in kidney. Octreotide improves antioxidant levels and histology in renal tissue and might be a treatment option

Case report on the development of a brucellosis-related epidural abscess

Brucellosis is an endemic disease in developing countries. The most commonly observed complications include bone-joint involvement, particularly sacroiliitis and spondylitis. Epidural abscesses caused by brucellosis are a rare complication. We describe the case of a 33-year-old man presenting with high fever, back pain, and weakness. At physical examination, the patient was found to be paraparetic. At thoracic MRI, spondylodiscitis and epidural abscess with significant cord compression were observed. In laboratory examinations, Rose Bengal and tube agglutination tests were positive in patient's serum for brucellosis, and specific antibiotherapy was initiated. Total laminectomy was performed and the abscess was aspirated. The biopsy sample was consistent with chronic non-specific inflammation in acute abscess. No growth was detected in the abscess or blood cultures. Following surgery, medical treatment was initiated and, at six weeks' follow-up, clinical and MRI findings indicated that he had recovered. The diagnosis of spinal epidural abscess due to brucellosis should be considered among differential diagnoses in endemic regions. Early diagnosis and specific treatment are important to prevent later complications

Idiopathic hypereosinophilic syndrome: a case report

Hypereosinophilic syndrome is a spectrum of disorders characterized by marked eosinophilic leukocytosis without identifiable cause or organ dysfunction. We report 37 years old man applied with nonproductive cough and itchy skin eruptions for one year. At the physical examination there were nodular erythematous lesions on his upper extremity. We didn't find any reason which can explain the eosinophily like allergic disease, mycotic infections, parasitic infections, malignancy and collagen tissue diseases with his anamnesis, clinical findings and laboratory tests. He was diagnosed as hypereosinopyhilic syndrome, and treated with hydroxiure. After treatment his skin lesions, leukocytosis and eosinophily were regressed

The impact of the COVID-19 pandemic on well-being of seniors attending online programs at University of the Third Age: a follow-up study

Background Reports on psychological effects of quarantine during past outbreaks and pandemics showed that quarantined people were more likely to experience psychological problems than those who were not. It was also shown that there was an increase in anxiety, depression, and stress in all age groups during the COVID-19 pandemic. So, we investigated emotional states and quality of life as components of general well-being in older participants of University of the Third Age (U3A) attending online programs during the second year of the pandemic, and compared them with the pre-pandemic COVID-19 period. Methods This study was conducted among 27 participants of a U3A program. Data on sociodemographics, Charlson comorbidity index, the Geriatric Depression Scale Short Form (GDS-SF), The Geriatric Anxiety Scale (GAS), and Turkish version of World Health Organization Quality of Life Instrument Older Adults Module (WHOQOL-OLD) were taken in September 2019 and September 2021. Results The median age of the participants was 68 (60-75) years (81.5% female). In the COVID-19 pandemic period; 'Death and dying' (except for 'Fear of pain before death' score), 'Intimacy' domain, and 'Social participation' domain scores of WHOQOL-OLD decreased compared to the pre-pandemic period (P < 0.001, P = 0.011, and P < 0.001, respectively) whereas the scores for GAS and GDS-SF were higher (P < 0.001 and P = 0.011). The reason for the decrease in 'Social participation' domain scores was the decrease in 'Satisfaction with opportunity to participate in community'. There was no significant difference in 'Autonomy' domain of WHOQOL-OLD (P = 0.598). Conclusion Although there was no change in 'Autonomy' domain among the participants of U3A before and during the pandemic period, anxiety and depression scores were higher in the second year of the COVID pandemic. Only a decrease in satisfaction with opportunity to participate in community might have significant impact on social participation

5GrEEn : Towards Green 5G Mobile Networks

In 2020, mobile access networks will experience significant challenges as compared to the situation of today. Traffic volumes are expected to increase 1000 times, and the number of connected devices will be 10-100 times higher than today in a networked society with unconstrained access to information and sharing of data available anywhere and anytime to anyone and anything. One of the big challenges is to provide this 1000-fold capacity increase to billions of devices in an affordable and sustainable way. Low energy consumption is the key to achieve this. This paper takes as starting point the situation of today, and tries to pinpoint important focus areas and potential solutions when designing an energy efficient 5G mobile network architecture. These include system architecture, where a logical separation of data and control planes is seen as a promising solution; network deployment, where (heterogeneous) ultra dense layouts will have a positive effect; radio transmission, where the introduction of massive antenna configurations is identified as an important enabler; and, finally, backhauling solutions that need to be more energy efficient than today. QC 20131028Towards Green 5G Mobile Networks (5GrEEn

User Experience Improving of a Grocery E-Commerce Solution.

Lietotāju pieredzes rodās, tikai tad, kad persona lieot kādu produktu vai internetveikalu, kā rezultātā savstarpēji rodas mijiedarbība. Lietotāju pieredzes noteicšo aspekts, var būt kvaltitāte, kurai ir iepsējams noteikt, vai lietotājs lietos produktu vēlreiz vai nelietos. Autora darbā tiek aprakstītas 7 aspekti no kurām pieci (atrodamība, ticamība, noderīgums, pieejamība un lietojamība) ir plašāk aprakstīti, novērtēšanas kritērīji un testēšanas metodes. Pētijuma rezultātā ir salīdzināti 3 Baltijas valstīs un 4 pasaulē populārākie pārtikas tirdzniedzības internetveikali. Darba gaitā tika izvēlēti novērtēšanas kritērīji, kā arī apstiprinātas iegūtās teorētiskās zināšanas izmantojot A/B testēšanu, lietotāju intervijas un aptaujas metodi kā arī veicot praktisku novērojumu.The user experience only occurs when a person uses a product or online store, resulting in interactions with each other. The determinants of the user experience can be the quality that makes it possible to determine whether or not the user will use the product again. The author's work describes 7 aspects, five of which (findability, reliability, usefulness, availability and usability) are described in more detail in the evaluation criteria and testing methods. As a result of the research, the 3 most popular grocery retail online stores in the Baltic States and 4 in the world have been compared. During the work, the evaluation criteria were selected, as well as the acquired theoretical knowledge was confirmed using A / B testing, user interviews and survey method, as well as by performing practical observation

Pretreatment with nebivolol attenuates level and expression of matrix metalloproteinases in a rat model of renal ischaemia-reperfusion injury

WOS: 000415374400013PubMed ID: 28118507AimMatrix metalloproteinases (MMPs) are zinc-containing proteinases that are involved in the degradation of extracellular matrix (ECM) and a number of cell surface proteins in order to maintain tissue homeostasis. They are involved in pathogenesis of several ischaemic organ injuries. In the present study, we aimed to determine the expression and level of MMP-2 and MMP-9 in renal ischaemia-reperfusion injury (IRI) model and the potential beneficial effect of nebivolol, a (1)-adrenergic receptor blocker, on both MMP-2 and -9 level and expression and tubular injury caused by IRI. MethodsTwenty Wistar albino rats were divided into three groups: sham-operated , ischaemia-reperfusion, and nebivolol-pretreated. IRI model was induced by bilateral clamping of renal arteries for 45min followed by 24h of reperfusion. The analysis of serum creatinine levels, quantity and expression of MMP-2 and MMP-9 were performed after 24h of IRI. The effects of nebivolol on level and expression of MMP-2 and MMP-9 levels were investigated by enzyme-linked immunosorbent assay and immunohistochemistry, respectively. The pathological examinations were performed to score tubular damage by light microscopy. ResultsCreatinine levels increased significantly in the ischaemia-reperfusion group compared to the sham-operated group. Rats in the nebivolol-pretreated group showed significant decrease in expression and quantity of MMP-2 and MMP-9 during IRI. The pathological examinations demonstrated significantly low level of tubular injury score in nebivolol-pretreated group. ConclusionNebivolol attenuated IRI by decreasing the expression and level of MMP-2 and MMP-9. Summary at a Glance This study demonstrated that nebivolol ((1) receptor blocker) attenuated renal ischemia-reperfusion injury (IRI) in rats by decreasing the expression levels of the extracellular matrix-degrading enzymes, matrix metalloproteinase (MMP)-2 and -9. Nebivolol was administered 7 days prior to IRI and inhibited IRI-induced tubular injury and creatinine levels

Monitoring nonlinear dynamics of change in a single case of psychodynamic play therapy

A systematic single case study with a mixed quantitative and qualitative methodology was conducted to investigate the nonlinear dynamics of change in play profiles of a child in psychodynamic play therapy. The first aim of the study was to cluster the different features of play characteristics (i.e., descriptive, cognitive, affective, and social characteristics of play, and the defensive strategies used in play) in order to construct the different play profiles of this child, and secondly to assess the transitions between profiles over the course of treatment. It was expected that there would be an increase in critical fluctuations during the transitions between the profiles and an increase in the variability of play profiles. Results showed that the child's play characteristics clustered into eight states and three attractors. The Markov Transition Matrix showed how play profiles evolved over time. Entropy analyses comparing the first and the second half of therapy showed an increase in variability. Qualitative analyses indicated the importance of expression of the child's underlying fear, and its integration with overt anger in the generation of the new play profiles. The results indicate an increase in variability, and a destabilization of old play profiles that were used towards generating new play profiles