Effects of perioperative intravenous omega-3 fatty acids in colon cancer patients:a randomized, double-blind, placebo-controlled clinical trial

Background: The postoperative inflammatory response contributes to tissue healing and recovery but overwhelming inflammation is associated with postoperative complications. n-3 (ω-3) PUFAs modulate inflammatory responses and may help to prevent a proinflammatory cascade. Objectives: We aimed to investigate the effects of perioperative intravenous n-3 PUFAs on inflammatory cytokines in colon cancer surgery. Methods: This study is a randomized, double-blind, placebo-controlled clinical trial. Forty-four patients undergoing elective colon resection for nonmetastasized cancer were randomly assigned to 2 intravenous n-3 PUFA or saline control infusions the night before and the morning after surgery. Blood was sampled at 6 perioperative time points for changes in cytokines in serum and in LPS-stimulated whole blood samples and leukocyte membrane fatty acid profiles. Results: Twenty-three patients received saline and 21 patients received n-3 PUFAs. Patient and operation characteristics were equal between groups, except for open resection (saline n = 5 compared with n-3 PUFA n = 0, P = 0.056). Ex-vivo IL-6 after LPS stimulation was significantly higher in the n-3 PUFA group at the first day after surgery (P = 0.014), but not different at the second day after surgery (P = 0.467). White blood cell count was higher in the n-3 PUFA group at the fourth day after surgery (P = 0.029). There were more patients with infectious complications in the n-3 PUFA group (8 compared with 3, P = 0.036). There were no overall differences in serum IL-6, IL-10, C-reactive protein, and length of stay. The administration of n-3 PUFAs resulted in rapid increases in leukocyte membrane n-3 PUFA content. Conclusions: In the n-3 PUFA group a clear relation with serum and LPS-stimulated cytokines was not found but, unexpectedly, more infectious complications occurred. Caution is thus required with the off-label use of a perioperative intravenous n-3 PUFA emulsion as a standalone infusion in the time sequence reported in the present study in colon resections with primary anastomosis. This trial was registered at clinicaltrials.gov as NCT02231203

Attitudes of Older Adults in a Group-Based Exercise Program Toward a Blended Intervention:A Focus-Group Study

Ageing is associated with a decline in daily functioning and mobility. A physically active life and physical exercise can minimize the decline of daily functioning and improve the physical-, psychological- and social functioning of older adults. Despite several advantages of group-based exercise programs, older adults participating in such interventions often do not meet the frequency, intensity or duration of exercises needed to gain health benefits. An exercise program that combines the advantages of group-based exercises led by an instructor with tailored home-based exercises can increase the effectiveness. Technology can assist in delivering a personalized program. The aim of the study was to determine the susceptibility of older adults currently participating in a nationwide group-based exercise program to such a blended exercise program. Eight focus-groups were held with adults of 55 years of age or older. Two researchers coded independently the remarks of the 30 participants that were included in the analysis according to the three key concepts of the Self Determination Theory: autonomy, competence and relatedness. The results show that maintaining self-reliance and keeping in touch with others were the main motives to participate in the weekly group-based exercises. Participants recognized benefits of doing additional home-based exercises, but had concerns regarding guidance, safety and motivation. Furthermore, some participants strongly rejected the idea to use technology to support them in doing exercises at home, but the majority was open to it. Insights are discussed how these findings can help design novel interventions that can increase the wellbeing of older adults and preserve an independent living.

Protocolized Versus Nonprotocolized Weaning to Reduce the Duration of Invasive Mechanical Weaning in Neonates A Systematic Review of All Types of Studies

Mechanical ventilation is one of the most commonly used treatments in neonatology. Prolonged mechanical ventilation is associated with deleterious outcomes. To reduce the ventilation duration, weaning protocols have been developed to achieve extubation in adult and pediatric care in a safe and uniform manner. We performed a systematic review to obtain all available evidence on the effect of protocolized versus nonprotocolized weaning on the duration of invasive mechanical ventilation in critically ill neonates. The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, Web of Science, and the International Clinical Trial Registry Platform were searched until January 2018. Quantitative and qualitative studies involving neonates that investigated or described protocolized versus nonprotocolized weaning were included. Primary outcome was the difference in weaning duration. A total of 2099 potentially relevant articles were retrieved. Three stud

Bodem Vitaal! : naar het begrijpen en sturen van bodemvitaliteit

Bodemvitaliteit is essentieel voor duurzame landbouw en natuurontwikkeling. De enorme rijkdom aan biodiversiteit en de aantallen organismen bepalen de bodemvitaliteit. Er is dus kennis nodig om te weten te komen welke organismen van de geweldige complexe biodiversiteit in de bodem verantwoordelijk zijn voor bodemweerbaarheid. Bodem Vitaal! stelt zich tot doel fundamentale instrumenten te ontwikkelen voor het ontrafelen van bodemweerbaarheid en voor het sturen van bodemvitaliteit

The kinematics and chemical stratification of the Type Ia supernova remnant 0519-69.0

We present an analysis of the XMM-Newton and Chandra X-ray data of the young Type Ia supernova remnant 0519-69.0 in the Large Magellanic Cloud. We used data from both the Chandra ACIS and XMM-Newton EPIC-MOS instruments, and high resolution X-ray spectra obtained with the XMM-Newton Reflection Grating Spectrometer. The Chandra data show that there is a radial stratification of oxygen, intermediate mass elements and iron, with the emission from more massive elements more toward the center. Using a deprojection technique we measure a forward shock radius of 4.0(3) pc and a reverse shock radius of 2.7(4) pc. We took the observed stratification of the shocked ejecta into account in the modeling of the X-ray spectra with multi-component NEI models, with the components corresponding to layers dominated by one or two elements. An additional component was added in order to represent the ISM, which mostly contributed to the continuum emission. This model fits the data well, and was also employed to characterize the spectra of distinct regions extracted from the Chandra data. From our spectral analysis we find that the fractional masses of shocked ejecta for the most abundant elements are: M(O)=32%, M(Si/S)=7%/5%, M(Ar+Ca)=1%, and M(Fe) = 55%. From the continuum component we derive a circumstellar density of nH= 2.4(2)/cm^3. This density, together with the measurements of the forward and reverse shock radii suggest an age of 450+/-200 yr,somewhat lower than, but consistent with the estimate based on the optical light echo (600+/-200 yr). From the RGS spectra we measured a Doppler broadening of sigma=1873+/-50 km/s, from implying a forward shock velocity of vS = 2770+/-500 km/s. We discuss the results in the context of single degenerate explosion models, using semi-analytical and numerical modeling, and compare the characteristics of 0519-69.0 with those of other Type Ia supernova remnants.Comment: Astronomy and Astrophysics in press. This version is the A&A accepted version, which contains improved figures and an extended discussion sectio

Comparative genomics among cyst nematodes reveals distinct evolutionary histories among effector families and an irregular distribution of effector-associated promoter motifs

JvS, MH and SvdE were supported by a grant from the Applied and Technical Science domain (TTW) of the Netherlands Organization for Scientific Research (NWO) under grant no. 14708. PT received support from the University of St Andrews Bioinformatics Unit (AMD3BIOINF), funded by Wellcome Trust ISSF award 105621/Z/14/Z. MS benefitted from funding by a VENI grant (17282) from the NWO domain Applied and Engineering Sciences.Potato cyst nematodes (PCNs), an umbrella term used for two species, Globodera pallida and G. rostochiensis, belong worldwide to the most harmful pathogens of potato. Pathotype-specific host plant resistances are an essential handle for PCN control. However, the poor delineation of G. pallida pathotypes hampers the efficient use of available host plant resistances. Long-read sequencing technology allowed us to generate a new reference genome of G. pallida population D383 and, as compared to the current reference, the new genome assembly is 42 times less fragmented. For comparison of diversification patterns of six effector families between G. pallida and G. rostochiensis, an additional reference genome was generated for an outgroup, the beet cyst nematode Heterodera schachtii (IRS population). Large evolutionary contrasts in effector family topologies were observed. While VAPs diversified before the split between the three cyst nematode species, the families GLAND5 and GLAND13 only expanded in PCN after their separation from the genus Heterodera. Although DNA motifs in the promoter regions thought to be involved in the orchestration of effector expression ('DOG boxes') were present in all three cyst nematode species, their presence is not a necessity for dorsal gland-produced effectors. Notably, DOG box dosage was only loosely correlated with expression level of individual effector variants. Comparison of the G. pallida genome with those of two other cyst nematodes underlined the fundamental differences in evolutionary history between effector families. Re-sequencing of PCN populations with deviant virulence characteristics will allow for the linking of these characteristics with the composition of the effector repertoire as well as for the mapping of PCN diversification patterns resulting from extreme anthropogenic range expansion.Publisher PDFPeer reviewe