27 research outputs found

    Suicidality in patients with obsessive-compulsive and related disorders (OCRDs): A meta-analysis

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    © 2021 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/Introduction Previous meta-analyses showed that OCD is associated with a substantial risk of suicidal behaviours. Conclusive rates of suicidal ideation (current and lifetime) and suicide attempts based on pooled prevalence rates have not so far been calculated using meta-analysis for the other DSM-5 Obsessive-Compulsive Related Disorders (OCRDs). Objectives This meta-analysis aims to separately calculate the pooled prevalence rates of lifetime suicide attempts and current or lifetime suicidal ideation in BDD, Hoarding Disorder (HD), Skin Picking Disorder (SPD) and Trichotillomania (TTM) and to identify factors associated with increased suicide rates. Methods Our protocol was pre-registered with PROSPERO (CRD42020164395). A systematic review and meta-analysis following PRISMA reporting guidelines was performed by searching in PubMed/Medline, PsycINFO, Web of Science and CINAHL databases from the date of the first available article to April 20th, 2020. Stata version 15 was used for the statistical analysis. Given the small number of studies in TTM and SPD, the two grooming disorders were grouped together. Meta-analyses of proportions based on random effects (Der-Simonian and Laird method) were used to derive the pooled estimates. Results Thirty-nine studies (N=4559 participants) were included: 23 for BDD, 8 for HD, 7 for Grooming Disorders. For BDD, the pooled prevalence of lifetime suicide attempts, current and lifetime suicidal ideation was, respectively 35.2% (CI:23.4-47.8), 37.2% (CI:23.8-51.6) and 66.1% (CI:53.5-77.7). For HD, the pooled prevalence of lifetime suicide attempts, current and lifetime suicidal ideation was 24.1% (CI:12.8-37.6), 18.4% (CI:10.2-28.3) and 38.3% (CI:35.0-41.6), respectively. For Grooming Disorders, the pooled prevalence of lifetime suicide attempts and current suicidal ideation were 13.3% (CI:5.9-22.8) and 40.4% (CI:35.7-45.3), respectively (no data available for lifetime suicidal ideation). Conclusions The OCRDs as a group are associated with relatively high rates of suicidal behaviour. Through indirect comparisons, we infer that BDD has the greatest risk. Comorbid substance abuse, possibly reflecting poor underlying impulse control, is associated with higher rates of suicidal behaviour in BDD. Our data emphasize the need for clinicians to consider the risk of suicidal behaviour in the management of patients presenting with all forms of OCRDs.Peer reviewe

    Nutritional intake and food sources in an adult urban Kenyan population

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    Publisher Copyright: © 2022 The Authors. Nutrition Bulletin published by John Wiley & Sons Ltd on behalf of British Nutrition Foundation.Urbanisation is hastening the transition from traditional food habits to less healthy diets, which are becoming more common among Kenyans. No up-to-date studies on usual dietary intake and the main food sources of adult Kenyans are available. The aim of the present study was to identify the main food sources of nutrients in the diet of urban adult Kenyans and explore potential associations with demographic variables including age, sex, level of education, occupation and body mass index. The study adopted a cross-sectional design. The dietary intake of 486 adult Kenyans from Nairobi was assessed using a validated, culture-sensitive, semi-quantitative food frequency questionnaire. Binary logistic regression models were used to evaluate associations between food sources and demographic variables. Macronutrient intakes as a proportion of total energy intake (TEI) were within international dietary guidelines. Cereals and grain products (34.0%), sugar, syrups, sweets and snacks (9.8%), fruits (9.7%) and meat and eggs (8.8%) were the major contributors to TEI. Cereals and grain products contributed 42.5% to carbohydrates, followed by fruits (12.4%) and sugar, syrups, sweets and snacks (10.6%). The most important sources of protein and total fat were cereals and grain products (23.3% and 19.7%, respectively) and meat and eggs (22.0% and 18.7%, respectively). Sex, age and level of education were associated with the choice of food groups. Although macronutrient intakes were within guidelines, the Kenyan diet was revealed to be high in sugars, salt and fibre, with differences in food sources according to demographic variables. These results can act as an incentive to national authorities to implement nutritional strategies aiming to raise awareness of healthier dietary patterns among Kenyans.Peer reviewe

    Birth preparedness and complication readiness among women of reproductive age in Kenya and Tanzania : a community-based cross-sectional survey

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    Background: Delayed health-seeking continues to contribute to preventable maternal and neonatal deaths in low resource countries. Some of the strategies to avoid the delay include early preparation for the birth and detection of danger signs. We aimed to assess the level of practice and factors associated with birth preparedness and complication readiness (BPCR) in Kenya and Tanzania. Methods: We conducted community-based multi-stage cross-sectional surveys in Kilifi and Kisii counties in Kenya and Mwanza region in Tanzania and included women who delivered two years preceding the survey (2016–2017). A woman who mentioned at least three out of five BPCR components was considered well-prepared. Bivariate and multivariable proportional odds model were used to determine the factors associated with the BPCR. The STROBE guidelines for cross-sectional studies informed the design and reporting of this study. Results: Only 11.4% (59/519) and 7.6% (31/409) of women were well-prepared for birth and its complications in Kenya and Tanzania, respectively, while 39.7 and 30.6% were unprepared, respectively. Level of education (primary: adjusted odds ratio (aOR): 1.59, 95% CI: 1.14–2.20, secondary: aOR: 2.24, 95% CI: 1.39–3.59), delivery within health facility (aOR: 1.63, 95% CI: 1.15–2.29), good knowledge of danger signs during pregnancy (aOR: 1.28, 95% CI: 0.80– 2.04), labour and childbirth (aOR: 1.57, 95% CI: 0.93–2.67), postpartum (aOR: 2.69, 95% CI: 1.24–5.79), and antenatal care were associated with BPCR (aOR: 1.42, 95% CI: 1.13–1.78). Conclusion: Overall, most pregnant women were not prepared for birth and its complications in Kilifi, Kisii and Mwanza region. Improving level of education, creating awareness on danger signs during preconception, pregnancy, childbirth, and postpartum period, and encouraging antenatal care and skilled birth care among women and their male partners/families are recommended strategies to promote BPCR practices and contribute to improved pregnancy outcomes in women and newborns

    Understanding Factors Associated With Psychomotor Subtypes of Delirium in Older Inpatients With Dementia

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    GWAS of random glucose in 476,326 individuals provide insights into diabetes pathophysiology, complications and treatment stratification

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    Conventional measurements of fasting and postprandial blood glucose levels investigated in genome-wide association studies (GWAS) cannot capture the effects of DNA variability on ‘around the clock’ glucoregulatory processes. Here we show that GWAS meta-analysis of glucose measurements under nonstandardized conditions (random glucose (RG)) in 476,326 individuals of diverse ancestries and without diabetes enables locus discovery and innovative pathophysiological observations. We discovered 120 RG loci represented by 150 distinct signals, including 13 with sex-dimorphic effects, two cross-ancestry and seven rare frequency signals. Of these, 44 loci are new for glycemic traits. Regulatory, glycosylation and metagenomic annotations highlight ileum and colon tissues, indicating an underappreciated role of the gastrointestinal tract in controlling blood glucose. Functional follow-up and molecular dynamics simulations of lower frequency coding variants in glucagon-like peptide-1 receptor (GLP1R), a type 2 diabetes treatment target, reveal that optimal selection of GLP-1R agonist therapy will benefit from tailored genetic stratification. We also provide evidence from Mendelian randomization that lung function is modulated by blood glucose and that pulmonary dysfunction is a diabetes complication. Our investigation yields new insights into the biology of glucose regulation, diabetes complications and pathways for treatment stratification

    Ανάπτυξη βιοδιεργασιών για την παραγωγή 1,3-προπανοδιόλης και 2,3-βουτανοδιόλης με χρήση αποβλήτων τροφίμων και ακατέργαστων ανανεώσιμων πρώτων υλών από βιομηχανίες παραγωγής βιοντήζελ και επεξεργασίας ζαχαροκάλαμου

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    The development of a bio-based and circular economy has been identified as a necessary step to achieve the successful transition into a sustainable economy independent of fossil resources. The development of novel sustainable technologies is required for efficient conversion of renewable raw materials into bio-based chemicals, polymers, fuels and energy. This thesis presents novel research on bioprocess development for the production of 1,3-propanediol (PDO), 2,3-butanediol (BDO) and acetoin from food waste and crude renewable resources from biodiesel and cane sugar production plants. The aforementioned bio-based chemicals could be used as additives in high-value applications (e.g. flavour and fragrances) or precursors for the production of bio-based polymers and commodity products. Soybean cake (SBC) and crude glycerol, produced as by-products from biodiesel production processes using soybean as feedstock, were used as sole raw materials for PDO production using two bacterial strains of Citrobacter freundii. SBC was converted into a nutrient-rich hydrolysate by crude enzymes produced via solid state fermentation. The effect of initial glycerol and free amino nitrogen concentration on bacterial growth and PDO production was evaluated in batch bioreactor cultures showing that C. freundii VK-19 is a more efficient PDO producer than C. freundii FMCC-8. The cultivation of C. freundii VK-19 in fed-batch bioreactor cultures using crude glycerol and SBC hydrolysates led to PDO concentration of 47.4 g L-1 with yield and productivity of 0.49 g g-1 and 1.01 g L-1 h-1, respectively. The effect of PDO, metabolic by-products and sodium and potassium salts on bacterial growth was evaluated showing that potassium salts initially enhance bacterial growth, whereas sodium salts cause significant inhibition to bacterial growth. Different crude glycerols, derived from a biodiesel production plant using either soybean oil alone or two mixtures of soybean oil and tallow fat as feedstocks, were evaluated for BDO production by Klebsiella michiganensis. The effect of nitrogen source, temperature and initial glycerol concentration on bacterial growth and BDO production was studied in shake flask cultures. Using a synthetic medium with ammonium sulphate as nitrogen source favoured BDO production. The optimum temperature was 30 ˚C. The bacterial strain K. michiganensis could grow and produce BDO even at high initial crude glycerol concentrations when this stream was derived from biodiesel production using only soybean oil. BDO production by K. michiganensis was subsequently evaluated in fed-batch bioreactor fermentations using different types of crude glycerol and various volumetric oxygen transfer coefficients (kLa). The highest BDO concentration (87.6 g L-1) was reached using crude glycerol produced from soybean oil derived biodiesel with constant kLa value of 62 h-1 during fermentation. The highest productivity (1.38 g L-1 h-1) with reasonable BDO concentration (76.1 g L-1) and yield (0.41 g g-1) were reached when the same glycerol and kLa value of 77 h-1 were used. Lower BDO production efficiency was achieved with crude glycerols derived from biodiesel production with soybean oil and tallow fats as feedstock. The production of D-BDO and acetoin using the GRAS strain Bacillus amyloliquefaciens from very high polarity (VHP) cane sugar and sugarcane molasses has been evaluated. The effect of initial substrate concentration, nitrogen source, temperature, inoculum size and pH has been evaluated in shake flask cultures. Batch bioreactor cultures showed that D-BDO production (up to 28 g L-1) with high yield (up to 0.43 g g-1) and productivity (up to 0.93 g L-1 h-1) was favored at low kLa values (17 – 49 h-1). Increasing kLa values (63 – 104 h-1) caused metabolic shift towards acetoin production (up to 25.6 g L-1) with yields up to 0.4 g g-1 and productivities up to 1.42 g L-1 h-1. Fed-batch fermentation carried out at kLa value of 49 h-1 with VHP cane sugar resulted in mixed production (127.3 g L-1) of D-BDO, meso-BDO and acetoin at 122 h with high yield (0.50 g g-1) and productivity (1.04 g L-1 h-1). In a similar fed-batch fermentation with sugarcane molasses, mainly D-BDO production (48.7 g L-1 with purity of 87.8%) was achieved at 59 h with yield of 0.40 g g-1 and productivity of 0.83 g L-1 h-1. At 130 h, D-BDO was converted mainly into acetoin (55.4 g L-1). Fed-batch cultures with sugarcane molasses could lead to either D-BDO or acetoin production with negligible by-product formation.The GRAS strain B. amyloliquefaciens was also evaluated for D-BDO and acetoin production using enzymatically produced bakery waste hydrolysates in bench top and pilot scale bioreactors. Manipulation of kLa during fermentation may control metabolic shift in B. amyloliquefaciens cells towards either D-BDO or acetoin production. Batch cultures with kLa value of 64 h-1 led to the highest D-BDO concentration (55.2 g L-1) with a yield of 0.42 g g-1. The highest acetoin concentration (47.4 g L-1) with productivity of 2.16 g L-1 h-1 was achieved in batch cultures with the highest kLa value (203 h-1) used. It was verified that kLa can be used as scale-up parameter for conducting fermentations in 50 L bioreactor scale. Fed-batch fermentation may increase further D-BDO and acetoin production efficiency.Η παραγωγή προϊόντων βιο-οικονομίας αποτελεί μια νέα αναπτυξιακή στρατηγική για τη μετάβαση προς μια βιώσιμη και ενεργειακά ανεξάρτητη από ορυκτά καύσιμα οικονομία. Η ανάπτυξη καινοτόμων και αειφόρων τεχνολογιών απαιτείται για τη χρήση ανανεώσιμων πρώτων υλών προς την παραγωγή χημικών ουσιών, πολυμερών, καυσίμων και ενέργειας. Η παρούσα διδακτορική διατριβή εστιάζει στην ανάπτυξη βιοδιεργασιών βασισμένων στη βιομηχανική βιοτεχνολογία για την παραγωγή 1,3-προπανοδιόλης (PDO), 2,3-βουτανοδιόλης (BDO) και ακετοΐνης με χρήση αποβλήτων τροφίμων και ακατέργαστων ανανεώσιμων πρώτων υλών από βιομηχανίες παραγωγής βιοντήζελ και ζάχαρης από ζαχαροκάλαμο. Σογιάλευρα και ακατέργαστη γλυκερόλη που παράγονται ως παραπροϊόντα από διεργασίες παραγωγής βιοντήζελ χρησιμοποιήθηκαν ως πρώτες ύλες για την παραγωγή PDO μέσω ζύμωσης με δύο βακτηριακά στελέχη Citrobacter freundii. Τα σογιάλευρα χρησιμοποιήθηκαν για την παραγωγή υδρολύματος πλούσιου σε θρεπτικά συστατικά με χρήση ακατέργαστων ενζύμων που παρήχθησαν μέσω ζύμωσης στερεάς κατάστασης. Η επίδραση της αρχικής συγκέντρωσης γλυκερόλης και του αζώτου των ελευθέρων αμινομάδων αμινοξέων και πεπτιδίων στην μικροβιακή ανάπτυξη και στην παραγωγή PDO μελετήθηκε σε καλλιέργειες διαλείποντος έργου. Ικανοποιητική παραγωγή PDO σημειώθηκε από το βακτηριακό στέλεχος C. freundii VK-19 συγκριτικά με το C. freundii FMCC-8. Η πραγματοποίηση ζυμώσεων ημι-διαλείποντος έργου με χρήση ακατέργαστης γλυκερόλης και υδρολύματος σογιάλευρου οδήγησε στην παραγωγή 47,4 g L-1 PDO με απόδοση 0,49 g g-1 και παραγωγικότητα 1,01 g L-1 h-1. Τα άλατα καλίου αρχικά αύξησαν την μικροβιακή ανάπτυξη, ενώ τα άλατα νατρίου προκαλούν σημαντική παρεμπόδιση της μικροβιακής ανάπτυξης.Η παραγωγή BDO με χρήση διαφορετικών ακατέργαστων γλυκερολών μελετήθηκε χρησιμοποιώντας το βακτηριακό στέλεχος Klebsiella michiganensis. Μελετήθηκε η επίδραση της πηγής αζώτου, της θερμοκρασίας και της αρχικής συγκέντρωσης γλυκερόλης δείχνοντας ότι η ανόργανη πηγή αζώτου και η θερμοκρασία των 30 ˚C μεγιστοποιούν την παραγωγή BDO. Το βακτηριακό στέλεχος Κ. michiganensis αναπτύσσεται και παράγει BDO ακόμα και σε υψηλές αρχικές συγκεντρώσεις ακατέργαστης γλυκερόλης. Ακολούθως, μελετήθηκε η παραγωγή BDO μέσω ζυμώσεων ημι-διαλείποντος έργου που πραγματοποιήθηκαν υπό διαφορετικές τιμές kLa και τύπους ακατέργαστων γλυκερολών. Η υψηλότερη συγκέντρωση BDO (87,8 g L-1) παρήχθη με χρήση τιμής kLa ίσης με 62 h-1. Η μεγαλύτερη παραγωγικότητα (1,38 g L-1 h-1) με συγκέντρωση BDO ίσης με 76,1 g L-1 και απόδοσης ίσης με 0,41 g g-1 επιτεύχθηκε σε τιμή kLa ίσης με 77 h-1. Η χρήση ακατέργαστης γλυκερόλης προερχόμενη από μείγμα σογιελαίου και ζωικού λίπους είχε ως αποτέλεσμα τη μείωση της παραγωγής BDO. Ακατέργαστη ζάχαρη και μελάσα μελετήθηκαν ως πρώτες ύλες για την παραγωγή D-BDO και ακετοΐνης από το βακτηριακό στέλεχος Bacillus amyloliquefaciens. Αρχικά, μελετήθηκε η επίδραση της πηγής αζώτου, της θερμοκρασίας, του εμβολίου, της παροχής οξυγόνου και του pΗ στη μικροβιακή αύξηση και στην παραγωγή μεταβολικών προϊόντων μέσω ζυμώσεων σε αναδευόμενες φιάλες. Ζυμώσεις διαλείποντος έργου σε βιοαντιδραστήρα σε μικρές τιμές kLa (17 – 49 h-1) ευνοούν την παραγωγή D-BDO, ενώ υψηλότερες τιμές kLa (63 – 104 h-1) ευνοούν την παραγωγή ακετοΐνης. Στη συνέχεια, πραγματοποιήθηκαν ζυμώσεις ημι-διαλείποντος έργου χρησιμοποιώντας ακατέργαστη ζάχαρη και μελάσα. Η χρήση διαφορετικών διαλυμάτων τροφοδοσίας οδήγησε σε διαφορετική αναλογία των ισομερών της BDO και της ακετοΐνης κατά τη διάρκεια της ζύμωσης. Η χρήση ακατέργαστης μελάσας οδήγησε στην παραγωγή κυρίως D-BDO (48,7 g L-1 με καθαρότητα 87,8%) στις 59 h ζύμωσης με απόδοση 0,40 g g-1 και παραγωγικότητα 0,83 g L-1 h-1. Στις 130 h, η D-BDO μετατράπηκε κυρίως σε ακετοΐνη (55,4 g L-1). Πραγματοποίηση ζύμωσης με αποκλειστική χρήση μελάσας οδήγησε στην παραγωγή είτε D-BDO είτε ακετοΐνης, ενώ ταυτόχρονα δεν παρατηρήθηκε παραγωγή άλλων μεταβολικών προϊόντων. Το βακτηριακό στέλεχος Bacillus amyloliquefaciens αξιολογήθηκε ως προς την παραγωγή D-BDO και ακετοΐνης με χρήση υδρολύματος από απόβλητα αρτοποιίας που παρήχθη με χρήση ενζύμων. Η μεταβολή της τιμής του kLa κατά τη διάρκεια της ζύμωσης μπορεί να χρησιμοποιηθεί για να στρέψει το μεταβολισμό του B. amyloliquefaciens προς την παραγωγή είτε D-BDO είτε ακετοΐνης. Ζυμώσεις διαλείποντος έργου σε εργαστηριακό βιοαντιδραστήρα και τιμή kLa ίσης με 64 h-1 είχε ως αποτέλεσμα την παραγωγή της υψηλότερης συγκέντρωσης D-BDO (55,1 g L-1) με απόδοση 0,42 g g-1. Η μεγαλύτερη συγκέντρωση ακετοΐνης (47,4 g L-1) και παραγωγικότητας (2,31 g L-1 h-1) επετεύχθη σε ζυμώσεις διαλείποντος έργου με τιμή kLa ίσης με 203 h-1. Τα πειραματικά αποτελέσματα επιβεβαίωσαν ότι το kLa μπορεί να χρησιμοποιηθεί για την αύξηση κλίμακας ζυμώσεων σε βιοαντιδραστήρα 50 λίτρων. Η πραγματοποίηση ζυμώσεων ημι-διαλείποντος έργου δύναται να αυξήσει την παραγωγή D-BDO και ακετοΐνης

    Prospects on bio-based 2,3-butanediol and acetoin production: Recent progress and advances

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    The bio-based platform chemicals 2,3-butanediol (BDO) and acetoin have various applications in chemical, cosmetics, food, agriculture, and pharmaceutical industries, whereas the derivatives of BDO could be used as fuel additives, polymer and synthetic rubber production. This review summarizes the novel technological developments in adapting genetic and metabolic engineering strategies for selection and construction of chassis strains for BDO and acetoin production. The valorization of renewable feedstocks and bioprocess development for the upstream and downstream stages of bio-based BDO and acetoin production are discussed. The techno-economic aspects evaluating the viability and industrial potential of bio-based BDO production are presented. The commercialization of bio-based BDO and acetoin production requires the utilization of crude renewable resources, the chassis strains with high fermentation production efficiencies and development of sustainable purification or conversion technologies

    Bioconversions of Biodiesel-Derived Glycerol into Sugar Alcohols by Newly Isolated Wild-Type <i>Yarrowia lipolytica</i> Strains

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    The utilization of crude glycerol, generated as a by-product from the biodiesel production process, for the production of high value-added products represents an opportunity to overcome the negative impact of low glycerol prices in the biodiesel industry. In this study, the biochemical behavior of Yarrowia lipolytica strains FMCC Y-74 and FMCC Y-75 was investigated using glycerol as a carbon source. Initially, the effect of pH value (3.0–7.0) was examined to produce polyols, intracellular lipids, and polysaccharides. At low pH values (initial pH 3.0–5.0), significant mannitol production was recorded. The highest mannitol production (19.64 g L−1) was obtained by Y. lipolytica FMCC Y-74 at pH = 3.0. At pH values ranging between 5.0 and 6.0, intracellular polysaccharides synthesis was favored, while polyols production was suppressed. Subsequently, the effect of crude glycerol and its concentration on polyols production was studied. Y. lipolytica FMCC Y-74 showed high tolerance to impurities of crude glycerol. Initial substrate concentrations influence polyols production and distribution with a metabolic shift toward erythritol production being observed when the initial glycerol concentration (Gly0) increased. The highest total polyols production (=56.64 g L−1) was obtained at Gly0 adjusted to ≈120 g L−1. The highest polyols conversion yield (0.59 g g−1) and productivity (4.36 g L−1 d−1) were reached at Gly0 = 80 g L−1. In fed-batch intermittent fermentation with glycerol concentration remaining ≤60 g L−1, the metabolism was shifted toward mannitol biosynthesis, which was the main polyol produced in significant quantities (=36.84 g L−1) with a corresponding conversion yield of 0.51 g g−1

    Integrated fermentative production and downstream processing of 2,3-butanediol from sugarcane bagasse-derived xylose by mutant strain of Enterobacter ludwigii

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    In this study, a mutant strain of Enterobacter ludwigii developed in our previous work, was evaluated to utilize pure xylose as the sole carbon and energy source for 2,3-butanediol (BDO) production. Later, this strain was also investigated on detoxified and nondetoxified xylose-rich hydrolysate obtained from hydrothermally pretreated sugarcane bagasse (SCB) for BDO production. Supplementing the fermentation medium with 0.2% w/v yeast extract improved cell growth (31%), BDO titer (43%), and yield (41%) against the synthetic medium devoid of any complex nitrogen source. The fed-batch culture with cyclic control of pH resulted in a BDO production of 71.1 g/L from pure xylose with overall yield and productivity of 0.40 g/g and 0.94 g/L·h, respectively. While BDO titer, yield, and productivity of 63.5 g/L, 0.36 g/g, and 0.84 g/L·h, were acheived with detoxified hydrolysate, respectively. In contrast, 32.7 g/L BDO was produced from nondetoxified hydrolysate with a conversion yield of 0.33 g/g and a productivity of 0.43 g/L·h. BDO accumulated on pure xylose and detoxified SCB hydrolysate was separated by aqueous two-phase system (ATPS) method using (NH4)2SO4 as salting-out agent and isopropanol as an extractant, resulting in the BDO recovery of more than 85%. The results achieved in the current work exemplify a step toward industrial BDO production from cost-effective hemicellulosic hydrolysates by E. ludwigii
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