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- ArticleHaider S, Batool Z, Rafiq S.MethodsX. 2020;7:101059.A large portion of the human population is exposed to traumatic events once in their lifetime, 10% of which may undergo post-traumatic stress disorder (PTSD). It is a mental condition triggered by a traumatic event resulting in severe anxiety disorder which may severely affect the daily routine life of the individual. The patient expresses the aversive memory by recalling any fear event related to the traumatic experience. The disruption of fear memory related to fear event is one of the best approaches to treat PTSD. In this regard, pharmacological interventions provide a possible way to erase or lessen the fear memory of the traumatic event. The screening and identification of drugs is one of the crucial steps to introduce new potent drugs in preclinical setup. Pavlovian fear conditioning is the well known experimental protocol to study fear memory. In this article, we are presenting a detailed method of Pavlovian fear conditioning which we have optimized in our lab for the identification of drugs having the potential to disrupt fear memory in the PTSD-rat model. In this protocol, various stages of memory formation including consolidation, reconsolidation, and extinction have been targeted to study the effect of a particular drug.•The protocol provides step by step procedure to study the effects of known or putative drugs in an animal model of PTSD.•The method also explains the separate protocols to target specific stages of memory so that one can identify the effects of drugs on a particular phase of remote or recent memory formation.
- ArticleBass JJ, Nakhuda A, Deane CS, Brook MS, Wilkinson DJ, Phillips BE, Philp A, Tarum J, Kadi F, Andersen D, Garcia AM, Smith K, Gallagher IJ, Szewczyk NJ, Cleasby ME, Atherton PJ.Mol Metab. 2020 12;42:101059.OBJECTIVE: The Vitamin D receptor (VDR) has been positively associated with skeletal muscle mass, function and regeneration. Mechanistic studies have focused on the loss of the receptor, with in vivo whole-body knockout models demonstrating reduced myofibre size and function and impaired muscle development. To understand the mechanistic role upregulation of the VDR elicits in muscle mass/health, we studied the impact of VDR over-expression (OE) in vivo before exploring the importance of VDR expression upon muscle hypertrophy in humans.
METHODS: Wistar rats underwent in vivo electrotransfer (IVE) to overexpress the VDR in the Tibialis anterior (TA) muscle for 10 days, before comprehensive physiological and metabolic profiling to characterise the influence of VDR-OE on muscle protein synthesis (MPS), anabolic signalling and satellite cell activity. Stable isotope tracer (D2O) techniques were used to assess sub-fraction protein synthesis, alongside RNA-Seq analysis. Finally, human participants underwent 20 wks of resistance exercise training, with body composition and transcriptomic analysis.
RESULTS: Muscle VDR-OE yielded total protein and RNA accretion, manifesting in increased myofibre area, i.e., hypertrophy. The observed increases in MPS were associated with enhanced anabolic signalling, reflecting translational efficiency (e.g., mammalian target of rapamycin (mTOR-signalling), with no effects upon protein breakdown markers being observed. Additionally, RNA-Seq illustrated marked extracellular matrix (ECM) remodelling, while satellite cell content, markers of proliferation and associated cell-cycled related gene-sets were upregulated. Finally, induction of VDR mRNA correlated with muscle hypertrophy in humans following long-term resistance exercise type training.
CONCLUSION: VDR-OE stimulates muscle hypertrophy ostensibly via heightened protein synthesis, translational efficiency, ribosomal expansion and upregulation of ECM remodelling-related gene-sets. Furthermore, VDR expression is a robust marker of the hypertrophic response to resistance exercise in humans. The VDR is a viable target of muscle maintenance through testable Vitamin D molecules, as active molecules and analogues. - ArticleSivandzade F, Prasad S, Bhalerao A, Cucullo L.Redox Biol. 2019 02;21:101059.Electrophiles and reactive oxygen species (ROS) play a major role in modulating cellular defense mechanisms as well as physiological functions, and intracellular signaling. However, excessive ROS generation (endogenous and exogenous) can create a state of redox imbalance leading to cellular and tissue damage (Ma and He, 2012) [1]. A growing body of research data strongly suggests that imbalanced ROS and electrophile overproduction are among the major prodromal factors in the onset and progression of several cerebrovascular and neurodegenerative disorders such as amyotrophic lateral sclerosis (ALS), stroke, Alzheimer's disease (AD), Parkinson's disease (PD), and aging (Ma and He, 2012; Ramsey et al., 2017; Salminen et al., 2012; Sandberg et al., 2014; Sarlette et al., 2008; Tanji et al., 2013) [1-6]. Cells offset oxidative stress by the action of housekeeping antioxidative enzymes (such as superoxide dismutase, catalase, glutathione peroxidase) as well direct and indirect antioxidants (Dinkova-Kostova and Talalay, 2010) [7]. The DNA sequence responsible for modulating the antioxidative and cytoprotective responses of the cells has been identified as the antioxidant response element (ARE), while the nuclear factor erythroid 2-related factor (NRF2) is the major regulator of the xenobiotic-activated receptor (XAR) responsible for activating the ARE-pathway, thus defined as the NRF2-ARE system (Ma and He, 2012) [1]. In addition, the interplay between the NRF2-ARE system and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-ĸB, a protein complex that controls cytokine production and cell survival), has been further investigated in relation to neurodegenerative and neuroinflammatory disorders. On these premises, we provide a review analysis of current understanding of the NRF2-NF-ĸB interplay, their specific role in major CNS disorders, and consequent therapeutic implication for the treatment of neurodegenerative and cerebrovascular diseases.
- ArticleSmadi AA, Abugabah A, Al-Smadi AM, Almotairi S.Inform Med Unlocked. 2022;32:101059.COVID-19 detection from medical imaging is a difficult challenge that has piqued the interest of experts worldwide. Chest X-rays and computed tomography (CT) scanning are the essential imaging modalities for diagnosing COVID-19. All researchers focus their efforts on developing viable methods and rapid treatment procedures for this pandemic. Fast and accurate automated detection approaches have been devised to alleviate the need for medical professionals. Deep Learning (DL) technologies have successfully recognized COVID-19 situations. This paper proposes a developed set of nine deep learning models for diagnosing COVID-19 based on transfer learning and implementation in a novel architecture (SEL-COVIDNET). We include a global average pooling layer, flattening, and two dense layers that are fully connected. The model's effectiveness is evaluated using balanced and unbalanced COVID-19 radiography datasets. After that, our model's performance is analyzed using six evaluation measures: accuracy, sensitivity, specificity, precision, F1-score, and Matthew's correlation coefficient (MCC). Experiments demonstrated that the proposed SEL-COVIDNET with tuned DenseNet121, InceptionResNetV2, and MobileNetV3Large models outperformed the results of comparative SOTA for multi-class classification (COVID-19 vs. No-finding vs. Pneumonia) in terms of accuracy (98.52%), specificity (98.5%), sensitivity (98.5%), precision (98.7%), F1-score (98.7%), and MCC (97.5%). For the COVID-19 vs. No-finding classification, our method had an accuracy of 99.77%, a specificity of 99.85%, a sensitivity of 99.85%, a precision of 99.55%, an F1-score of 99.7%, and an MCC of 99.4%. The proposed model offers an accurate approach for detecting COVID-19 patients, which aids in the containment of the COVID-19 pandemic.
- ArticleMcGuire M, de Waal A, Karellis A, Janssen R, Engel N, Sampath R, Carmona S, Zwerling AA, Suarez MF, Pai NP.EClinicalMedicine. 2021 Sep;39:101059.BACKGROUND: HIV self-testing (HIVST) is recommended by the WHO as an innovative strategy to reach UNAIDS targets to end HIV by 2030. HIVST with digital supports is defined as the use of digital interventions (e.g., website-based, social media, mobile HIVST applications (apps), text messaging (SMS), digital vending machines (digital VMs)) to improve the efficiency and impact of HIVST. HIVST deployment and integration in health services is an emerging priority. We conducted a systematic review aiming to close the gap in evidence that summarizes the impact of digitally supported HIVST and to inform policy recommendations.
METHODS: We searched PubMed and Embase for articles and abstracts on HIVST with digital supports published during the period February 1st, 2010 to June 15th, 2021, following Cochrane guidelines and PRISMA methodology. We assessed feasibility, acceptability, preference, and impact outcomes across all populations and study designs. Metrics reported were willingness to use HIVST, preferences for HIVST delivery, proportion of first-time testers, HIVST uptake, HIVST kit return rate, and linkage to care. Heterogeneity of the interventions and reported metrics precluded us from conducting a meta-analysis.
FINDINGS: 46 studies were narratively synthesized, of which 72% were observational and 28% were RCTs. Half of all studies (54%, 25/46) assessed web-based innovations (e.g., study websites, videos, chatbots), followed by social media (26%, 12/46), HIVST-specific apps (7%, 3/46), SMS (9%, 4/46), and digital VMs (4%, 2/46). Web-based innovations were found to be acceptable (77-97%), preferred over in-person and hybrid options by more first-time testers (47-48%), highly feasible (93-95%), and were overall effective in supporting linkage to care (53-100%). Social media and app-based innovations also had high acceptability (87-95%) and linkage to care proportions (80-100%). SMS innovations increased kit return rates (54-94%) and HIVST uptake among hard-to-reach groups. Finally, digital VMs were highly acceptable (54-93%), and HIVST uptake was six times greater when using digital VMs compared to distribution by community workers.
INTERPRETATION: HIVST with digital supports was deemed feasible, acceptable, preferable, and was shown to increase uptake, engage first-time testers and hard-to-reach populations, and successfully link participants to treatment. Findings pave the way for greater use of HIVST interventions with digital supports globally. - ArticleYin QJ, Tang HZ, Zhu FC, Liu X, Xing YZ, Tang LC, Li XG.Mar Genomics. 2023 Oct;71:101059.Rossellomorea sp. DA94, isolated from mangrove sediment in the South China Sea (Beihai, Guangxi province), is an agarolytic and orange-pigmented bacterium. Here, we present the complete genome sequence of strain DA94, which comprises 4.63 Mb sequences with 43.5% GC content. In total, 4589 CDSs, 33 rRNA genes and 110 tRNA genes were obtained. Genomic analysis of strain DA94 revealed that 108 CAZymes were organized in 4578 PULs involved in polysaccharides degradation, transport, and regulation. Further, we performed the diversity of CAZymes and PULs comparison among Rossellomorea strains. Less CAZymes were organized more PULs, indicating highly efficiently polysaccharides utilization in Rossellomorea. Meanwhile, PUL0459, PUL0460 and PUL0316 related to agar degradation, and exolytic beta-agarase GH50, endo-type beta-agarase GH86 and arylsulfatase were identified in the genome of strain DA94. We verified that strain DA94 can degrade agar to form a bright clear zone around the bacterial colonies in the laboratory. Moreover, the carotenoid biosynthetic pathways were proposed, which may be responsible for orange-pigment of Rossellomorea sp. DA94. This study represents a thorough genomic characterization of CAZymes repertoire and carotenoid biosynthetic pathways of Rossellomorea, provides insight into diversity of related enzymes and their potential biotechnological applications.
- ArticleShi Y, Wu J, Zhong T, Zhu W, She G, Tang H, Du W, Ye BC, Qi N.iScience. 2020 May 22;23(5):101059.The monomer-to-filament transition of MAVS is essential for the RIG-I/MDA5-mediated antiviral signaling. In quiescent cells, monomeric MAVS is under strict regulation for preventing its spontaneous aggregation, which would result in dysregulated interferon (IFN-α/β) production and autoimmune diseases like systemic lupus erythematosus. However, the detailed mechanism by which MAVS is kept from spontaneous aggregation remains largely unclear. Here, we show that upstream open reading frames (uORFs) within the MAVS transcripts exert a post-transcriptional regulation for preventing MAVS spontaneous aggregation and auto-activation. Mechanistically, we demonstrate that uORFs are cis-acting elements initiating leaky ribosome scanning of the downstream ORF codons, thereby repressing the full-length MAVS translation. We further uncover that endogenous MAVS generated from the uORF-deprived transcript spontaneously aggregates, triggering the Nix-mediated mitophagic clearance of damaged mitochondria and aggregated MAVS. Our findings reveal the uORF-mediated quantity and quality control of MAVS, which prevents aberrant protein aggregation and maintains innate immune homeostasis.
- ArticleDeoni SCL, D'Sa V, Volpe A, Beauchemin J, Croff JM, Elliott AJ, Pini N, Lucchini M, Fifer WP.Dev Cogn Neurosci. 2022 04;54:101059.The NIH HEALthy Brain and Cognitive Development (HBCD) study aims to characterize the impact of in utero exposure to substances, and related environmental exposures on child neurodevelopment and health outcomes. A key focus of HBCD is opioid exposure, which has disproportionately affected rural areas. While most opioid use and neonatal abstinence syndrome has been reported outside of large cities, rural communities are often under-represented in large-scale clinical research studies that involve neuroimaging, in-person assessments, or bio-specimen collections. Thus, there exists a likely mismatch between the communities that are the focus of HBCD and those that can participate. Even geographically proximal participants, however, are likely to bias towards higher socioeconomic status given the anticipated study burden and visit frequency. Wearables, 'nearables', and other consumer biosensors, however, are increasingly capable of collecting continuous physiologic and environmental exposure data, facilitating remote assessment. We review the potential of these technologies for remote in situ data collection, and the ability to engage rural, affected communities. While not necessarily a replacement, these technologies offer a compelling complement to traditional 'gold standard' lab-based methods, with significant potential to expand the study's reach and importance.
- ArticleTian Z, Shofer FS, Fan M, Sandroni AZ, Yao L, Han L, Qin L, Enomoto-Iwamoto M, Zhang Y.Genes Dis. 2024 May;11(3):101059.
- ArticleMaher EE, Strzelecki AM, Weafer JJ, Gipson CD.Front Neuroendocrinol. 2023 04;69:101059.Clinically, women appear to be more susceptible to certain aspects of substance use disorders (SUDs). The steroid hormones 17β-estradiol (E2) and progesterone (Pg) have been linked to women-specific drug behaviors. Here, we review clinical and preclinical studies investigating how cycling ovarian hormones affect nicotine-, cocaine-, and opioid-related behaviors. We also highlight gaps in the literature regarding how synthetic steroid hormone use may influence drug-related behaviors. In addition, we explore how E2 and Pg are known to interact in brain reward pathways and provide evidence of how these interactions may influence drug-related behaviors. The synthesis of this review demonstrates the critical need to study women-specific factors that may influence aspects of SUDs, which may play important roles in addiction processes in a sex-specific fashion. It is important to understand factors that impact women's health and may be key to moving the field forward toward more efficacious and individualized treatment strategies.
- ArticleHolbert SE, Brennan JC, Johnson AH, MacDonald JH, Turcotte JJ, King PJ.Arthroplast Today. 2023 Feb;19:101059.Background: Health disparities disproportionately affect minority groups across the United States with respect to care access, quality, and outcomes. The aim of this study is to examine existing disparities between white and African American (AA) patients regarding postoperative outcomes following total joint arthroplasty and provide insight into disparity trends over a 9-year period.
Methods: A retrospective review of 16,779 total joint arthroplasty patients at a single institution between January 2013 and December 2021 was performed. Patients were grouped by race as AA or white. Outcomes of interest included length of stay (LOS), home discharge, 30-day emergency department return, and 30-day readmission. Univariate statistics and multivariate regressions were utilized to analyze results.
Results: Significant improvements in LOS and rates of home discharge occurred for both white and AA patients at our institution over a 9-year period, while rates of 30-day emergency department returns and readmissions demonstrated a downward but non-statistically significant trend. Despite these trends, AA patients continued to experience longer lengths of stay, less likelihood of 0- or 1-day LOS, and higher risk of nonhome discharge for most years examined. However, after controlling for demographic and comorbidity differences, the differences between groups narrowed over time resulting in no significant differences in the aforementioned 3 measures by 2021.
Conclusions: Although racial disparities in outcomes are still apparent, over time, the differences in resource utilization between AA and white patients have narrowed. Initiatives aimed at creating healthier communities with increased access to care and the ultimate goal of equitable care must continue to be pursued. - ArticleSaharan US, Kumar R, Tripathy P, Sateesh M, Garg J, Sharma SK, Mandal TK.Urban Clim. 2022 Jan;41:101059.To curb the 2nd wave of COVID-19 disease in April-May 2021, a night curfew followed by full lockdown was imposed over the National Capital Territory, Delhi. We have analyzed the observed variation in pollutants and meteorology, and role of local and transboundary emission sources during night-curfew and lockdown, as compared to pre-lockdown period and identical periods of 2020 lockdown as well as of 2018 and 2019. In 2021, concentration of pollutants (except O₃, SO₂, and toluene) declined by 4-16% during night-curfew as compared to the pre-lockdown period but these changes are not statistically significant. During lockdown in 2021, various pollutants decreased by 1-28% as compared to the night-curfew (except O₃ and PM₂.₅), but increased by 31-129% compared to the identical period of 2020 lockdown except O₃. Advection of pollutants from the region of moderate lockdown restrictions and an abrupt increase in crop-residue burning activity (120-587%) over Haryana and Punjab increased the air pollution levels over NCT during the lockdown period of 2021 as compared to 2020 in addition to a significant contribution of long-range transport. The increase in PM₂.₅ during the lockdown period of 2021 compared to 2020 might led to 5-29 additional premature mortalities.
- ArticleMaurizi A, Ponzetti M, Gautvik KM, Reppe S, Teti A, Rucci N.Bone Rep. 2021 Jun;14:101059.PURPOSE: Lipocalin 2 (LCN2) is an adipokine involved in many physiological functions, including bone metabolism. We previously demonstrated its implication in mouse models of mechanical unloading-induced osteoporosis and in a cohort of bed rest volunteers. We therefore aimed at studying its involvement in postmenopausal osteoporosis.
METHODS: We measured serum LCN2 and correlated its levels to Dickkopf WNT Signaling Pathway Inhibitor 1 (DKK1), Tartrate Resistant Acid Phosphatase 5B (TRAcP5B), sclerostin, urinary N-terminal telopeptide of type I collagen (NTX), serum C-terminal telopeptide of type I collagen (CTX), parathyroid hormone and vitamin K by ELISA performed in a cohort of younger (50-65 years) and older (66-90 years) osteoporotic women in comparison to healthy subjects. A cohort of male healthy and osteoarthritic patients was also included. Sobel mediation analysis was used to test indirect associations among age, LCN2 and DKK1 or NTX.
RESULTS: LCN2 levels were unchanged in osteoporotic and in osteoarthritis patients when compared to healthy subjects and did not correlate with BMD. However, serum LCN2 correlated with age in healthy women (R = 0.44; P = 0.003) and men (R = 0.5; P = 0.001) and serum concentrations of DKK1 (R = 0.47; P = 0.003) and urinary NTX (R = 0.34; P = 0.04). Sobel mediation analysis showed that LCN2 mediates an indirect relationship between age and DKK1 (P = 0.02), but not with NTX, in healthy subjects.
CONCLUSIONS: Taken together, the results suggest a hitherto unknown association between LCN2, DKK1 and age in healthy individuals, but not in postmenopausal osteoporotic women. - ArticleAfrouziyeh M, Kwakkel RP, Zuidhof MJ.Poult Sci. 2021 May;100(5):101059.Growth models describe body weight (BW) changes over time, allowing information from longitudinal measurements to be combined into a few parameters with biological interpretation. Nonlinear mixed models (NLMM) allow for the inclusion of random factors. Random factors can account for a relatively large subset of the total variance explained by bird-specific measurement correlation. The aim of this study was to evaluate different NLMM using birds from 2 heritage chicken lines; New Hampshire (NH) and Brown Leghorn (BL). A total of 32 birds (16 mixed sex birds from each strain) were raised to 17 wk of age. After 12 wk, half were continued on ad libitum (AL) feed intake, and half were pair-fed, using a precision feeding system; they were given 95% of the AL intake of a paired bird closest in BW. Residual feed intake (RFI) of birds, as an indicator of production efficiency, was increased in pair-fed BL birds as a result of minor feed restriction. Growth data of the birds were fit to a mixed Gompertz model with a variety of different bird-specific random coefficients. The model had the form: [Formula: see text] ; where Wm was the mature BW, b was the rate of maturing, t was age (d), tinf was the inflection point (d). This fixed-effects model was compared with NLMM using model evaluation criteria to evaluate relative model suitability. Random coefficients, Wmu ∼ N(0,VWm) and bu ∼ N(0,Vb), were tested separately and together and their differences, for strains, sex, and feeding treatments, were reported as different where P ≤ 0.05. The model with both random coefficients was determined to be the most parsimonious model, based on an assessment of serial correlation of the residuals. NLMM coefficients allow stochastic prediction of the mean age and its variation that birds need to achieve a certain BW, allowing for unique new decision support modeling applications; these could be used in stochastic modeling to evaluate the economic impact of management decisions.
- ArticleGhosh S, Choi P, Brown SP, Motl RW, Agiovlasitis S.Disabil Health J. 2021 07;14(3):101059.BACKGROUND: There are limited data on the levels and patterns of sedentary behavior (SB) among U.S. adults with ID.
OBJECTIVE: To examine SB levels and patterns in U.S. adults with ID and how these differ between sexes, age-groups, and week vs. weekend days.
METHODS: Fifty-two adults with ID (25 men; age 45 ± 14 years) wore a hip accelerometer (wGT3X-BT; Actigraph) during the waking hours for 7 days. We determined total sedentary time, percent of wear time spent sedentary bouts ≥1, ≥10, ≥30, and ≥60 min, and breaks in sedentary time for bouts ≥10 min. We examined differences in SB variables as a function of sex, age-group by median split (≤48 vs. >48 years), and day of the week.
RESULTS: Total sedentary time was 514 ± 139 min · day-1 accumulated in bouts 1-30 min and did not differ between sexes or age-groups. Bouts ≥1 min across days were longer for men than women and longer during weekend days than weekdays (p < 0.05). The number of bouts ≥1 min was greater during weekdays than weekend days (p < 0.05). Bouts ≥60 min were longer for men than women (p < 0.05). The duration of sedentary breaks was longer during weekdays than weekend days (p < 0.001). There were no differences between age-groups.
CONCLUSIONS: Adults with ID spend a large portion of the day in SB primarily of short bouts. Despite small differences, SB levels and patterns were similar for men and women with ID and across age-groups throughout the week. - ArticleMessekher M, François H, Denis MG, Ferrer-Lopez P, Bost-Bezaud F, Mazières J, Parrat É.Respir Med Res. 2023 Nov;84:101059.
- ArticleWalton A, Toth AL.Curr Opin Insect Sci. 2023 08;58:101059.Eusocial insect societies are fundamentally non-egalitarian. The reproductive caste 'wins' in terms of resource accumulation, whereas non-reproductive workers 'lose'. Here, we argue that the division of labor among workers is also organized by nutritional inequalities. Across vastly different social systems and a variety of hymenopteran species, there is a recurrent pattern of lean foragers and corpulent nest workers. Experimental manipulations confirm causal associations between nutritional differences, associated molecular pathways, and behavioral roles in insect societies. The comparative and functional genomic data suggest that a conserved toolkit of core metabolic, nutrient storage, and signaling genes has evolved to regulate the social insect division of labor. Thus, the unequal distribution of food resources can be considered a fundamental organizing factor in the social insect division of labor.
- ArticlePrasoppokakorn T, Assanasen T, Chantranuwatana P, Suankratay C.Respir Med Case Rep. 2020;30:101059.BACKGROUND: Lymphoid interstitial pneumonia (LIP) is categorized as a rare form of interstitial lung disease. Most cases are associated with autoimmune disease.
CASE REPORT: A 78-year-old male with Crohn's disease, presented with progressive dyspnea and dry cough for few weeks. The pathology of transbronchial lung biopsy was compatible with LIP and positive cells on EBER in situ hybridization. Blood EBV viral load was 85,715 copies/mL, compatible with EBV-associated LIP. All immunosuppressive agents were discontinued, but unfortunately the patient died due to hospital-acquired infections. In addition, we reviewed all reported cases of EBV-associated LIP in literature.
CONCLUSIONS: To our knowledge, we report herein the first case of EBV-associated LIP in an IBD patient. We postulate that LIP was the consequence from EBV reactivation, probably due to immunosuppressive agents and/or IBD itself. The physician should aware of this disease when taking care of immunosuppressive patients who present with acute interstitial pneumonitis. - ArticleMojdehbakhsh RP, Al-Rubaye R, Huang DS, Connor J, Al-Niaimi A.Gynecol Oncol Rep. 2022 Oct;43:101059.Objectives: This study sought to compare differences in blood transfusion and surgical complication rates before and after the implementation of a restrictive blood transfusion protocol.
Methods: On July 1, 2018, our institution implemented a restrictive blood transfusion protocol utilizing a hemoglobin trigger of less than 7 g/dL. Retrospective chart review was completed to review patients undergoing major abdominal surgery by the gynecology and gynecologic oncology services 18 months before, and after initiation of the transfusion protocol. Outcomes included number of patients, units transfused and postoperative complication rates. Complications included reoperation on the day of admission, surgical site infections, wound disruptions, pulmonary, renal, central nervous system, and cardiovascular complications, as well as deep venous thromboses, readmissions, and 30-day mortality.
Results: There were 290 people in the pre- and 449 patients in the post-protocol group. A similar number of patients received blood transfusions in both groups (9.3% versus 10.6% p = 0.57). However, significantly fewer units of blood were given post-protocol initiation. For every patient who received a transfusion pre-protocol, 2.66 units were administered compared to 1.2 units after the protocol was initiated (p = 0.003). All postoperative complications were not significantly different between groups (p > 0.05). Individual postoperative complications were combined and analyzed using a clustered approach to detect rates of complications more conservatively. Both the 7-system (5.1% versus 4.9%, p = 0.90) and 8-system (5.5% versus 4.9%, p = 0.72) clustered analyses were not significantly different before and after the initiation of the transfusion protocol.
Conclusions: A restrictive transfusion protocol is effective in decreasing the number of units of blood transfused without affecting postoperative complication rates in gynecologic surgery patients. - ArticleTinitana-Bayas R, Sanjuán N, Jiménez ES, Lainez M, Estellés F.Animal. 2024 Feb;18(2):101059.Livestock production systems contribute significantly to environmental impacts at the global level, and meat consumption is projected to increase with the population. There is a need to reduce the impact of food production, including that from beef systems. Different production systems, ranging from traditional grazing to landless systems, coexist within the beef sector. Among these, mixed systems have emerged as a promising alternative. These mixed systems typically involve adult cattle in grazing systems alongside fattening calves in landless systems, potentially achieving higher productivity while reducing the overall environmental impacts. The first step towards proposing mitigation strategies involves identifying the impacts of the sector. This study aimed to estimate the main environmental impacts of four types of mixed beef systems based on the origin of the calves that are raised, fattened, and slaughtered. Using life cycle assessment, the study evaluated the environmental impacts from the cradle to the slaughterhouse gate, expressed per kilogram of carcass weight. The four systems assessed include suckler cow farms that fatten their own offspring (beef single farm, BSF), a system in which calves raised on a suckler farm are fattened on a different farm (beef fattening unit, BFU), and systems in which dairy calves are fattened on growing units, with calves either from Spain (dairy national, DN) or from farms located abroad (dairy abroad, DA). Primary data were obtained from representative surveys of farmers and slaughterhouses, and allocation between co-products was performed according to the updated guidelines of Environmental Product Declarations and the Product Category Rules for meat. Seven environmental impact categories were assessed: climate change, marine eutrophication, freshwater eutrophication, stratospheric ozone depletion, terrestrial acidification, photochemical ozone formation on ecosystems, and photochemical ozone formation on human health. The results indicate that meat production from BSF and BFU has greater environmental impacts than that from DN and DA systems, primarily due to the lower environmental burden allocated to dairy calves, whereas the contribution of slaughterhouse activities to the environmental impacts was minimal. This study highlights the importance of mitigating the environmental impacts associated with feed production, enteric fermentation, and manure management in beef systems. Future studies should consider potential environmental benefits of grazing animals such as carbon sequestration and biodiversity promotion.