The Osteoporosis Society of Hong Kong (OSHK): 2013 OSHK Guideline for Clinical Management of Postmenopausal Osteoporosis in Hong Kong

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Événements Bulletin

Événements Bulleti

Clinical update on acute cholecystitis and biliary pancreatitis: between certainties and grey areas

Acute calculous cholecystitis (ACC) and acute biliary pancreatitis (ABP) are significant complications of gallstone disease. This review aims to provide a comprehensive analysis of current management practices for ACC and ABP. The Tokyo Guidelines (TG) and World Society of Emergency Surgery (WSES) guidelines recommend early laparoscopic cholecystectomy (ELC) as the treatment of choice for ACC. High-risk patients may benefit from alternative treatments like biliary drainage, with emerging techniques such as endoscopic drainage showing promise. ABP requires prompt diagnosis and intervention. The Revised Atlanta Classification (RAC) criteria are used for diagnosis, with endoscopic retrograde cholangiopancreatography (ERCP) and cholecystectomy as primary treatments. Minimally invasive approaches are preferred for managing complications like infected pancreatic necrosis, with the endoscopic step-up method showing superior outcomes. The management of ACC and ABP continues to evolve. Future research is needed to refine guidelines further and address existing controversies, ultimately improving patient outcomes in these acute biliary conditions

High Levels of Diversity Uncovered in a Widespread Nominal Taxon: Continental Phylogeography of the Neotropical Tree Frog

Species distributed across vast continental areas and across major biomes provide unique model systems for studies of biotic diversification, yet also constitute daunting financial, logistic and political challenges for data collection across such regions. The tree frog Dendropsophus minutus (Anura: Hylidae) is a nominal species, continentally distributed in South America, that may represent a complex of multiple species, each with a more limited distribution. To understand the spatial pattern of molecular diversity throughout the range of this species complex, we obtained DNA sequence data from two mitochondrial genes, cytochrome oxidase I (COI) and the 16S rhibosomal gene (16S) for 407 samples of D. minutus and closely related species distributed across eleven countries, effectively comprising the entire range of the group. We performed phylogenetic and spatially explicit phylogeographic analyses to assess the genetic structure of lineages and infer ancestral areas. We found 43 statistically supported, deep mitochondrial lineages, several of which may represent currently unrecognized distinct species. One major clade, containing 25 divergent lineages, includes samples from the type locality of D. minutus. We defined that clade as the D. minutus complex. The remaining lineages together with the D. minutus complex constitute the D. minutus species group. Historical analyses support an Amazonian origin for the D. minutus species group with a subsequent dispersal to eastern Brazil where the D. minutus complex originated. According to our dataset, a total of eight mtDNA lineages have ranges >100,000 km2. One of them occupies an area of almost one million km2 encompassing multiple biomes. Our results, at a spatial scale and resolution unprecedented for a Neotropical vertebrate, confirm that widespread amphibian species occur in lowland South America, yet at the same time a large proportion of cryptic diversity still remains to be discovered

Coal in the 21st Century: a climate of change and uncertainty

Coal presents a particular set of challenges when balancing energy policy goals. Despite presenting viable solutions to the problems of energy security and global energy poverty, coal struggles, given its greenhouse-gas drawbacks, in a world of increasingly harmful climate change. Notwithstanding the harm caused to the environment, coal remains an expanding low-price route to meeting local energy needs. It is forecasted to remain a major global resource for the foreseeable future. In the short term it is predicted to have a 26% share of the global energy mix. Recent years have witnessed severe deviations from previously stable trends in coal markets and policy dynamics. According to the predictions by the International Energy Agency (IEA), a variety of factors ranging from the planned phase-out of coal in countries such as Denmark, France and the UK, to changes in policy in China and import-dependency in India, and demand drop in the US have together resulted in the largest decline in coal production in 2015 since 1971 (IEA, Coal Information, 2016). This paper seeks to outline basic coal facts, recent market trends and directions globally and provides an overview of issues shaping the future of coal in the twenty-first century. This paper seeks to outline basic coal facts, recent market trends and directions globally and provide an overview of issues shaping the future of coal in the 21st century

Mapping QTL influencing gastrointestinal nematode burden in Dutch Holstein-Friesian dairy cattle

BACKGROUND: Parasitic gastroenteritis caused by nematodes is only second to mastitis in terms of health costs to dairy farmers in developed countries. Sustainable control strategies complementing anthelmintics are desired, including selective breeding for enhanced resistance. RESULTS AND CONCLUSION: To quantify and characterize the genetic contribution to variation in resistance to gastro-intestinal parasites, we measured the heritability of faecal egg and larval counts in the Dutch Holstein-Friesian dairy cattle population. The heritability of faecal egg counts ranged from 7 to 21% and was generally higher than for larval counts. We performed a whole genome scan in 12 paternal half-daughter groups for a total of 768 cows, corresponding to the approximately 10% most and least infected daughters within each family (selective genotyping). Two genome-wide significant QTL were identified in an across-family analysis, respectively on chromosomes 9 and 19, coinciding with previous findings in orthologous chromosomal regions in sheep. We identified six more suggestive QTL by within-family analysis. An additional 73 informative SNPs were genotyped on chromosome 19 and the ensuing high density map used in a variance component approach to simultaneously exploit linkage and linkage disequilibrium in an initial inconclusive attempt to refine the QTL map position

Earth observation applications for coastal sustainability: potential and challenges for implementation

Copyright remains with the author(s) or their institution(s). The coast is home to unique ecosystems, where complex ecological processes take place through the interaction of terrestrial, aquatic, atmospheric, and human landscapes. However, there are considerable knowledge and data gaps in achieving effective and future change-proof sustainable management of coastal zones around the world due to both technical and social barriers, as well as governance challenges. Currently, the role of Earth observation (EO) in addressing many of the recognised information gaps is small and under-utilised. While EO can provide much of the spatiotemporal information required for historical analysis and current status mapping, and offers the advantage of global coverage; its uptake can be limited by technical and methodological challenges associated mostly with lack of capacity and infrastructure, product accuracy and accessibility, costs, and institutional acceptance. While new initiatives and recent technological progress in the EO and information technology arena aim to tackle some of these issues so that EO products can be more easily used by non-EO experts, uptake is still limited.This paper discusses how EO can potentially inform transformative practices of planning in the coastal water zone, by using examples to demonstrate the EO potential in providing information relevant to decisionmaking framed by international agreements, such as the United Nations Agenda 2030, the Convention on Biological Diversity, and the Sendai Framework for Risk Reduction. By presenting evidence for how EO can contribute to innovative opportunities and data synergies at scale, the paper discusses opportunities and challenges for a more solution-led approach to sustainable coastal management.European Union’s Horizon 2020 research and innovation programme under grant agreement No. 687289 (Co-ReSyF project), the United Kingdom’s Natural Environment Research Council (NERC) under Grant NE/E009328 (GloboLakes project), and the Future Earth Coasts project.European Union’s Horizon 2020 research and innovation programme under grant agreement No. 687289 (Co-ReSyF project); United Kingdom’s Natural Environment Research Council (NERC) under Grant NE/E009328 (GloboLakes project); Future Earth Coasts project

The First Bromeligenous Species of Dendropsophus (Anura: Hylidae) from Brazil\u27s Atlantic Forest

We describe a new treefrog species of Dendropsophus collected on rocky outcrops in the Brazilian Atlantic Forest. Ecologically, the new species can be distinguished from all known congeners by having a larval phase associated with rainwater accumulated in bromeliad phytotelms instead of temporary or lentic water bodies. Phylogenetic analysis based on molecular data confirms that the new species is a member of Dendropsophus; our analysis does not assign it to any recognized species group in the genus. Morphologically, based on comparison with the 96 known congeners, the new species is diagnosed by its small size, framed dorsal color pattern, and short webbing between toes IV-V. The advertisement call is composed of a moderate-pitched two-note call (~5 kHz). The territorial call contains more notes and pulses than the advertisement call. Field observations suggest that this new bromeligenous species uses a variety of bromeliad species to breed in, and may be both territorial and exhibit male parental care

(In)dependência funcional na dependente relação de homens tetraplégicos com seus (in)substituíveis pais/cuidadores

Objetivou-se identificar elementos da classificação internacional de funcionalidade, incapacidade e saúde, aplicáveis ao cuidado domiciliar de homens adultos tetraplégicos, com vistas à redução da dependência de ajuda de seus pais para as atividades da vida diária, e o autocuidado. Os dados foram coletados de junho de 2004 a março de 2005, a partir de entrevista semi-estruturada, realizada com 8 adultos acometidos de lesão medular alta, e com experiência de usuários do cuidado domiciliar. Optou-se pela análise de conteúdo, a partir das categorias de significados pautadas nos seguintes resultados: suporte familiar: segurança para as funções corporais do incapacitado; tecnologia assistiva: inventividades para promoção da qualidade do cuidado; medos, futuro incerto e perda dos pais: limiares e fragilidades humanas; e ganhos funcionais: respostas objetivas das funções corporais. Conclui-se que o apoio da família e, em especial, a presença dos pais, são fundamentais para enfrentar as limitações e reagir na busca de equilíbrio na deficiência, incapacidade, desvantagem e saúde dessa clientela, preparando-a para o alcance de gradativos ganhos funcionais e independência para atividades cotidianas e autocuidado.El estudio tuvo como objetivo identificar elementos de la clasificación internacional de funcionalidad, incapacidad y salud, aplicables al cuidado domiciliario de hombres adultos cuadripléjicos, con el fin de reducir la dependencia de la ayuda de sus padres en las actividades de la vida diaria y el autocuidado. Los datos fueron reunidos entre junio de 2004 y marzo de 2005, sobre la base de una entrevista semiestructurada efectuada a 8 adultos que sufrían de lesión medular alta y que recibían normalmente cuidado domiciliario. Se optó por el sistema de análisis de contenidos a partir de las categorías de significados pautados en los siguientes resultados: apoyo familiar: seguridad para las funciones corporales del discapacitado; tecnología de apoyo: soporte tecnológico para optimizar la calidad de los cuidados; miedos; futuro incierto y pérdida de los padres: los umbrales y las fragilidades humanas; y ganancias funcionales: respuestas objetivas de las funciones corporales. Se concluyó en que el apoyo familiar y, en particular, la presencia de los padres, son fundamentales para enfrentar las limitaciones y reaccionar en la búsqueda de equilibrios en la deficiencia, incapacidad, desventajas y salud de tales pacientes, preparándolos para alcanzar en forma gradual mejoras funcionales e independencia para realizar actividades diarias y ocuparse del autocuidado.The objective of this study was to identify elements of the international classification of functioning, disability and health, applicable to quadriplegic men's home care, to reduce the dependence on their parents' help for activities of daily living and self-care. Data were collected from June 2004 to March 2005. Semi-structured interviews were performed with eight adults with high spinal cord lesions who were being cared for at home . Content analysis was performed based on the categories of meaning extrapolated and the following themes were discovered : family support: safety for the corporal functions of the disabled; supporting technology: inventiveness to promote quality care; fears, uncertain future and parents' loss: thresholds and human fragilities; and functional gains: objective response of body functions. In conclusion, family support, and especially the presence of parents, is fundamental to facing limitations and to reacting in the search for balance with the deficiency, disability, disadvantage and health of that population, preparing them to achieve gradual functional gain and independence for daily activities and self-care

Cuidadores de indivíduos com lesão medular: sobrecarga do cuidado

Estudo seccional que teve como objetivos avaliar a sobrecarga do cuidado para cuidadores de indivíduos com Lesão Traumática da Medula Espinhal (LTME) e a sua associação com as variáveis sociodemográficas (sexo e idade), estado de saúde (enfermidades autorrelatadas) e características do cuidado (tempo de cuidado em anos e horas diárias de cuidado). Os dados foram coletados por consulta aos prontuários e entrevistas individuais no domicílio utilizando o instrumento Caregiver Burden Scale (CBScale). Os resultados apontaram que a maior sobrecarga ocorreu nos domínios: ambiente, decepção e tensão geral. Apresentar problema de saúde (para todos os domínios do CBScale) e despender mais horas por dia nos cuidados (no domínio decepção) representaram as variáveis associadas à sobrecarga. Estudos de natureza mais confirmatória do que exploratória entre as variáveis estudadas poderão utilizar a medida de sobrecarga obtida nesta população de cuidadores de indivíduos com LTME