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Beta-blockers and physical frailty in patients with end-stage liver disease.
AimTo investigate beta-blocker (BB) use in patients with cirrhosis and determine their effects on physical frailty and overall survival.MethodsAdult outpatients with cirrhosis listed for liver transplantation underwent testing of physical frailty using the performance-based Liver Frailty Index, comprised of chair stands, grip strength, and balance testing, as well as self-reported assessments of exhaustion and physical activity. BB use was assessed from medical chart review. Univariable and multivariable logistic regression were performed to determine BB use and their association with measures of physical frailty. Competing risk analyses were performed to determine the effect of BB use on wait-list mortality, as defined by death or delisting for being too sick for transplant.ResultsOf 344 patients, 35% were female, median age was 60, median model for end stage liver disease was 15, and 53% were prescribed a BB. Compared to those not on BB, patients on BB were similar except for percentage female (25% vs 46%; P < 0.001) and BMI (29 vs 28; P = 0.008). With respect to tests of physical frailty, BB use was not associated with increased odds of frailty (by the Liver Frailty Index), exhaustion, or low physical activity. BB use was, however, significantly associated with a decreased adjusted risk of mortality (SHR 0.55; P = 0.005).ConclusionIn patients with cirrhosis awaiting liver transplantation, BB use is not associated with physical frailty. We confirmed the known survival benefits with BB use, and concerns about adverse effects should not deter their utilization when indicated
Growth performance, carcase characteristics and meat quality of crossbred bulls and heifers from double-muscled Belgian Blue sires and Brown Swiss, Simmental and Rendena dams
Growth, conformation, carcase and meat quality traits of crossbred calves obtained in the Alps from selected Belgian Blue sires (BB) and Brown Swiss (BS), Simmental (Si) and Rendena (Re) dams were studied, emphasising differences on dairy and dual purpose maternal breed. Six pens with five heifers (3 BB BS, 1 BB Si, 1 BB Re) and six pens with four young bulls (2 BB BS, 1 BB Si, 1 BB Re) were used. In total 53 crossbred calves were tested: 30 from BS dams and 23 from dual purpose (12 from Si and 11 from Re dams). Growth performances were measured, carcases were scored for muscle conformation and fatness, the fifth rib was dissected, and the Longissimus thoracis (LT) was analysed. The maternal breed had significant effects when the calves from dairy cows (BB BS) were compared to those of the dual pur- pose breeds (BB Si and BB Re), as at slaughter the former were 1.2% taller, 6.0% less in vivo muscle score, 5.0% less carcase muscle score, with a 13% greater proportion of bone in the rib, and their LT had 12.5% less drip losses, but 3% greater cooking losses and 25% greater shear force. It was concluded that when using a BB as a sire, the dam breed has influ- ence on the growth performance traits of the derived crossbreds, but the major influence would regard the carcase and meat quality traits. In the Alps, these differences are reflected in different sold prices of the crossbred calves from dairy and dual purpose breeds at local auctions
Solar Neutrinos as Background to Neutrinoless Double-beta Decay Experiments
Solar neutrinos interact within double-beta decay (\BB) detectors and
contribute to backgrounds for \BB\ experiments. Background contributions due to
charge-current solar neutrino interactions with \BB\ nuclei of Ge,
Se, Mo, Te, Xe, and Nd are evaluated.
They are shown to be significant for future high-sensitivity \BB\ experiments
that may search for Majorana neutrino masses in the inverted-hierarchy mass
region. The impact of solar neutrino backgrounds and their reduction are
discussed for future \BB\ experiments.Comment: proceedings submission for MEDEX 201
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