130 research outputs found

    Adipose tissue: a source of stem cells with potential for regenerative therapies for wound healing

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    YesInterest in adipose tissue is fast becoming a focus of research after many years of being considered as a simple connective tissue. It is becoming increasingly apparent that adipose tissue contains a number of diverse cell types, including adipose-derived stem cells (ASCs) with the potential to differentiate into a number of cell lineages, and thus has significant potential for developing therapies for regenerative medicine. Currently, there is no gold standard treatment for scars and impaired wound healing continues to be a challenge faced by clinicians worldwide. This review describes the current understanding of the origin, different types, anatomical location, and genetics of adipose tissue before discussing the properties of ASCs and their promising applications for tissue engineering, scarring, and wound healing.The authors thank the Plastic Surgery and Burns Research Unit at the University of Bradford, Bradford, UK for financial support for LV

    Blood-Brain Barrier Permeability and Long-Term Clinical and Imaging Outcomes in Cerebral Small Vessel Disease

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    BACKGROUND AND PURPOSE: Increased blood-brain barrier (BBB) permeability occurs in cerebral small vessel disease (SVD). It is not known if BBB changes predate progression of SVD. METHODS: We followed up patients with non-disabling lacunar or cortical stroke and BBB permeability MR imaging following their original stroke. About three years later, we assessed functional outcome (Oxford Handicap Score, OHS, poor outcome defined as 3-6), recurrent neurological events and white matter hyperintensity (WMH) progression on MRI. RESULTS: Amongst 70 patients, mean age 68 (SD±11) years, median time to clinical follow up was 39 months (IQR 30-45), median OHS was 2 (IQR 1-3); poor functional outcome was associated with higher baseline WMH score (p<0.001) and increased basal ganglia BBB permeability (p=0.046). Amongst 48 patients with follow-up MRI, WMH progression at follow-up was associated with baseline WMH (ANCOVA p<0.0001) and age (ANCOVA p=0.032). CONCLUSIONS: Further long term studies to evaluate the role of BBB dysfunction in progression of SVD are required in studies that are large enough to account for key prognostic influences such as baseline WMH and age

    Physiological effects of tourism and associated food provisioning in an endangered iguana

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    © The Author 2013. Deliberately feeding wildlife is an increasingly popular tourism-related activity despite a limited understanding of long-term impacts on the species being fed. As a result, tourist behaviours that may have adverse impacts on imperiled species have often been encouraged without the necessary evaluation or oversight. Here, we report the responses of Northern Bahamian Rock Iguanas (Cyclura cychlura) to human-visitation pressure and associated food provisioning. We compared a variety of blood chemistry parameters of iguanas subjected to supplemental feeding at popular tourist destinations with iguanas occurring on islands where supplemental feeding does not take place. We demonstrate that male and female iguanas inhabiting tourist-visited islands where supplemental feeding occurs do not differ in body condition or baseline stress and stress response (determined by corticosterone levels) compared with iguanas from non-visited islands. Both males and females from tourist-visited sites experienced a greater incidence of endoparasitic infection and atypical loose faeces. Indicators of dietary nutrition, including glucose, potassium, and uric acid values, also differed for both sexes from tourist-visited and unvisited islands. Male iguanas from visited islands differed significantly from those on non-visited islands in calcium, cholesterol, cobalt, copper, magnesium, packed cell volume, selenium, and triglyceride concentrations, whereas female iguanas from visited islands differed significantly in ionized calcium. Although the interpretation of these differences is challenging, chronic biochemical stressors could compromise individual health over time or decrease survivorship during periods of environmental stress. We suggest protocols that can be adopted throughout the region to ensure that supplemental feeding has fewer impacts on these long-lived iguanas

    Behavioural ‘nudging’ interventions to reduce low-value care for low back pain in the emergency department (NUDGED): protocol for a 2×2 factorial, before-after, cluster randomised trial

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    Introduction:Opioids and imaging are considered low-value care for most people with low back pain. Yet around one in three people presenting to the emergency department (ED) will receive imaging, and two in three will receive an opioid. NUDG-ED aims to determine the effectiveness of two different behavioural ‘nudge’ interventions on low-value care for ED patients with low back pain. Methods and analysis:NUDG-ED is a 2×2 factorial, open-label, before-after, cluster randomised controlled trial. The trial includes 8 ED sites in Sydney, Australia. Participants will be ED clinicians who manage back pain, and patients who are 18 years or over presenting to ED with musculoskeletal back pain. EDs will be randomly assigned to receive (i) patient nudges, (ii) clinician nudges, (iii) both interventions or (iv) no nudge control. The primary outcome will be the proportion of encounters in ED for musculoskeletal back pain where a person received a non-indicated lumbar imaging test, an opioid at discharge or both. We will require 2416 encounters over a 9-month study period (3-month before period and 6-month after period) to detect an absolute difference of 10% in use of low-value care due to either nudge, with 80% power, alpha set at 0.05 and assuming an intra-class correlation coefficient of 0.10, and an intraperiod correlation of 0.09. Patient-reported outcome measures will be collected in a subsample of patients (n≥456) 1 week after their initial ED visit. To estimate effects, we will use a multilevel regression model, with a random effect for cluster and patient, a fixed effect indicating the group assignment of each cluster and a fixed effect of time. Ethics and dissemination:This study has ethical approval from Southwestern Sydney Local Health District Human Research Ethics Committee (2023/ETH00472). We will disseminate the results of this trial via media, presenting at conferences and scientific publications.</p

    Bioenergy technology roadmap for Colombia

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    The importance of using bioenergy for reducing oil dependence and greenhouse gas (GHG) emissions, diversifying the energy portfolio and supporting rural development is been increasingly recognized in Colombia. Against this background, this roadmap provides a long-term vision and goals to sustainably deploy biofuel and biomass technologies in Colombia until 2030. The roadmap identifies barriers to bioenergy deployment and suggests specific actions that should be taken by stakeholders to accomplish the proposed goals. It adopts a methodology from the International Energy Agency for developing technology roadmaps and combines detailed energy modeling with experienced advice from over 30 bioenergy experts from the government, academia, industry and non-governmental organizations.Based on expert feedback, the roadmap defines two visions, which are translated into two scenarios for detailed evaluation:The first vision, which is analyzed in Scenario I, focuses on new technologies and targets their deployment for the production of biomethane, biomass-based power generation and combined-heat-and-power (CHP). It fixes the current mandate for blending first generation liquid biofuels. The second vision, which is analyzed in Scenario II, combines new and traditional technologies and targets a combination of new technologies for the production of biomethane, electricity and CHP with further growth of first generation biofuels. A detailed set of goals, milestones, technologies, policies and barriers are defined for each of the two visions. Long-term goals in the bioenergy area include: Biodiesel: increase the quota mandate to B20 in 2020 and B30 in 2030. Bioethanol: a) increase the quota mandate to E20 in 2025 and b) implement an E85 fuel program in 2030. Renewable diesel: achieve a 10% contribution (on an energy basis) of renewable diesel to the total diesel fuel production in 2030. Biomethane: use 5% of biomass residues and animal waste resources nationwide to produce biomethane to be injected into the natural gas network by 2030. Power generation and CHP: a) achieve a renewable power target of 10% by 2025, b) use 5% of the biogas from animal waste and municipal water treatment plants nationwide by 2030, c) use 100% of the biogas produced in the water treatment process of biodiesel production plants by 2030, d) use 10% of the municipal landfill gas produced nationwide by 2030. A detailed energy system model for Colombia is set up and used to evaluate impacts on energy demand, supply, infrastructure and GHG emissions for Scenarios I and II and a baseline scenario that assumes no change in policies or deployment of new technologies. A land use and trade model that is linked to the energy system model is used to estimate land requirements for accomplishing the roadmap targets. A subset of Scenario II (Scenario II with expansion) considers a significant expansion in the cultivation of land beyond the Valley of the Cauca River.Results for the baseline show significant reductions in the share of bioenergy in the primary energy demand and various sectors. In contrast, Scenarios I and II are characterized by an increased share of bioenergy. In both scenarios, the bioenergy share for power generation and natural gas supply grows to about 6% in 2030. However, the share of bioenergy in the primary energy demand still declines to about 10% in 2030.Relative to the baseline, in Scenario I, bioenergy-induced emissions reduction amounts to about 11 mio tons of CO2-eq. and savings in fossil fuels of 2 mio tons of oil equivalent (TOE). The share of bioenergy in road transport remains unchanged. In Scenario I, an increase in land for producing liquid biofuels and woodfuel to 0.67 mio ha by 2030 is expected. Scenario I can accomplish long-term emission targets with available land and turns out to be the most effective scenario in terms of emission reduction per additional hectare of land. In Scenario II bioenergy-induced emissions reduction relative to the baseline amounts to about 20 mio tons of CO2-eq. and savings in fossil fuels of about 4.5 mio TOE (Scenario II with expansion: 22 mio tons of CO2-eq. and 5.4 mio TOE). The share of bioenergy in road transport grows to 24%. An increase in land for producing liquid biofuels and woodfuel to 1.1 mio ha by 2030 is expected in Scenario II (Scenario II with expansion: 1.3 mio ha). However, emissions reductions per additional hectare of land are about four to five times less compared to Scenario I. The roadmap shows that the most effective policy measures to reduce greenhouse gas emissions would address power generation and CHP applications, which account for more than 50% in emission reductions. The bulk of these reductions in emissions come from avoiding methane release via landfill gas and biogas from animal waste through combustion in reciprocating engines, followed by CO2 emission reduction in biomass-based power generation, and policies on first generation biofuels (i.e. bioethanol, biodiesel and renewable diesel).</p

    Falls in Older Adults With Cancer: Evaluation by Oncology Providers

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    Falls in older adults are common. Screening for falls is quick, simple, and important because falls increase the risk of morbidity and mortality in older patients with cancer. The aim of this study was to evaluate oncology providers' recognition of and response to falls in older patients with cancer

    Geriatric assessment as an aide to understanding falls in older adults with cancer

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    In older adults, falls are a common cause of functional decline, institutionalization, and reduced quality of life. This study (1) investigates the prevalence of falls in a large sample of community-dwelling older adults with a cancer diagnosis and (2) evaluates the association of falls with domains of comprehensive geriatric assessment (CGA) that pertain to falls risk
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