Search

Background: Exposure to environmental chemicals has been associated with an elevated risk of heart failure (HF). However, the impact on early markers of HF, such as left ventricular dysfunction (LVD), remains limited. Objective: To establish a foundation of evidence regarding early HF markers and their association with environmental pollutants, a systematic review and meta-analysis was conducted. Methods: The search, conducted on October 13th, 2023, encompassed PubMed, Embase, and Web of Science without filters, focusing on observational studies reporting myocardial geometrical, structural, or functional alterations in individuals without a history of heart disease. This included the general adult population, workers, young people, and the elderly. The risk of bias was assessed using the ROBINS-I tool at both study and item levels. Results: The systematic review included 17 studies involving 43.358 individuals exposed to air pollution and 2038 exposed to heavy metals. Approximately 41% of the effect measures of associations reported significant abnormalities in myocardial structure or function. The metanalyses by pollutants categories indicated positive associations between LV systolic and diastolic abnormalities and exposure to PM2.5 [-0.069 (−0.104, −0.033); −0.044 (−0.062, −0.025)] and PM10 [-0.055 (−0.087, −0.022); −0.030 (−0.050, −0.010)] and NO2 [-0.042 (−0.071, −0.013); −0.021 (−0.037, −0.004)], as well as positive associations between lead exposure and LV systolic abnormalities [-0.033 (−0.051, −0.016)]. Conclusions: Existing evidence shows that specific early markers of HF may be associated with exposure to chemical pollutants. It is recommended to include such endpoints in new longitudinal and case-control studies to confirm further risk associations. These studies should consider co-exposures, account for vulnerable groups, and identify cardiotoxic compounds that may require regulation. When examining the link between myocardial abnormalities and envir

Contains fulltext : 300116.pdf (Publisher’s version ) (Open Access), BACKGROUND AND OBJECTIVES: Isavuconazole is a broad-spectrum antifungal agent for the management of invasive fungal disease. Optimised drug exposure is critical for patient outcomes, specifically in the critically ill population. Solid information on isavuconazole pharmacokinetics including protein binding in patients in the intensive care unit is scarce. We aimed to describe the total and unbound isavuconazole pharmacokinetics and subsequently propose a dosage optimisation strategy. METHODS: A prospective multi-centre study in adult intensive care unit patients receiving isavuconazole was performed. Blood samples were collected on eight timepoints over one dosing interval between days 3-7 of treatment and optionally on one timepoint after discontinuation. Total and unbound isavuconazole pharmacokinetics were analysed by means of population pharmacokinetic modelling using NONMEM. The final model was used to perform simulations to assess exposure described by the area under the concentration-time curve and propose an adaptive dosing approach. RESULTS: Population pharmacokinetics of total and unbound isavuconazole were best described by an allometrically scaled two-compartment model with a saturable protein-binding model and interindividual variability on clearance and the maximum binding capacity. The median (range) isavuconazole unbound fraction was 1.65% (0.83-3.25%). After standard dosing, only 35.8% of simulated patients reached a total isavuconazole area under the concentration-time curve > 60 mg·h/L at day 14. The proposed adaptive dosing strategy resulted in an increase to 62.3% of patients at adequate steady-state exposure. CONCLUSIONS: In critically ill patients, total isavuconazole exposure is reduced and protein binding is highly variable. We proposed an adaptive dosing approach to enhance early treatment optimisation in this high-risk population. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT04777058., 01 december 2023

Item does not contain fulltext

Item does not contain fulltext

Item does not contain fulltext, BACKGROUND: Dementia palliative care is increasingly subject of research and practice improvement initiatives. AIM: To assess any changes over time in the evaluation of quality of care and quality of dying with dementia by family caregivers. DESIGN: Combined analysis of eight studies with bereaved family caregivers' evaluations 2005-2019. SETTING/PARTICIPANTS: Family caregivers of nursing home residents with dementia in the Netherlands (n = 1189) completed the End-of-Life in Dementia Satisfaction With Care (EOLD-SWC; quality of care) and Comfort Assessment in Dying (EOLD-CAD, four subscales; quality of dying) instruments. Changes in scores over time were analysed using mixed models with random effects for season and facility and adjustment for demographics, prospective design and urbanised region. RESULTS: The mean total EOLD-SWC score was 33.40 (SD 5.08) and increased by 0.148 points per year (95% CI, 0.052-0.244; adjusted 0.170 points 95% CI, 0.055-0.258). The mean total EOLD-CAD score was 30.80 (SD 5.76) and, unadjusted, there was a trend of decreasing quality of dying over time of -0.175 points (95% CI, -0.291 to -0.058) per year increment. With adjustment, the trend was not significant (-0.070 EOLD-CAD total score points, 95% CI, -0.205 to 0.065) and only the EOLD-CAD subscale 'Well being' decreased. CONCLUSION: We identified divergent trends over 14 years of increased quality of care, while quality of dying did not increase and well-being in dying decreased. Further research is needed on what well-being in dying means to family. Quality improvement requires continued efforts to treat symptoms in dying with dementia.

Contains fulltext : 245524.pdf (Publisher’s version ) (Open Access), BACKGROUND: Dementia palliative care is increasingly subject of research and practice improvement initiatives. AIM: To assess any changes over time in the evaluation of quality of care and quality of dying with dementia by family caregivers. DESIGN: Combined analysis of eight studies with bereaved family caregivers' evaluations 2005-2019. SETTING/PARTICIPANTS: Family caregivers of nursing home residents with dementia in the Netherlands (n = 1189) completed the End-of-Life in Dementia Satisfaction With Care (EOLD-SWC; quality of care) and Comfort Assessment in Dying (EOLD-CAD, four subscales; quality of dying) instruments. Changes in scores over time were analysed using mixed models with random effects for season and facility and adjustment for demographics, prospective design and urbanised region. RESULTS: The mean total EOLD-SWC score was 33.40 (SD 5.08) and increased by 0.148 points per year (95% CI, 0.052-0.244; adjusted 0.170 points 95% CI, 0.055-0.258). The mean total EOLD-CAD score was 30.80 (SD 5.76) and, unadjusted, there was a trend of decreasing quality of dying over time of -0.175 points (95% CI, -0.291 to -0.058) per year increment. With adjustment, the trend was not significant (-0.070 EOLD-CAD total score points, 95% CI, -0.205 to 0.065) and only the EOLD-CAD subscale 'Well being' decreased. CONCLUSION: We identified divergent trends over 14 years of increased quality of care, while quality of dying did not increase and well-being in dying decreased. Further research is needed on what well-being in dying means to family. Quality improvement requires continued efforts to treat symptoms in dying with dementia.

Contains fulltext : 245524.pdf (Publisher’s version ) (Open Access), BACKGROUND: Dementia palliative care is increasingly subject of research and practice improvement initiatives. AIM: To assess any changes over time in the evaluation of quality of care and quality of dying with dementia by family caregivers. DESIGN: Combined analysis of eight studies with bereaved family caregivers' evaluations 2005-2019. SETTING/PARTICIPANTS: Family caregivers of nursing home residents with dementia in the Netherlands (n = 1189) completed the End-of-Life in Dementia Satisfaction With Care (EOLD-SWC; quality of care) and Comfort Assessment in Dying (EOLD-CAD, four subscales; quality of dying) instruments. Changes in scores over time were analysed using mixed models with random effects for season and facility and adjustment for demographics, prospective design and urbanised region. RESULTS: The mean total EOLD-SWC score was 33.40 (SD 5.08) and increased by 0.148 points per year (95% CI, 0.052-0.244; adjusted 0.170 points 95% CI, 0.055-0.258). The mean total EOLD-CAD score was 30.80 (SD 5.76) and, unadjusted, there was a trend of decreasing quality of dying over time of -0.175 points (95% CI, -0.291 to -0.058) per year increment. With adjustment, the trend was not significant (-0.070 EOLD-CAD total score points, 95% CI, -0.205 to 0.065) and only the EOLD-CAD subscale 'Well being' decreased. CONCLUSION: We identified divergent trends over 14 years of increased quality of care, while quality of dying did not increase and well-being in dying decreased. Further research is needed on what well-being in dying means to family. Quality improvement requires continued efforts to treat symptoms in dying with dementia.

In the last decade, several incidents with contaminants leaking from food packaging into food and drinks have raised concerns towards potential adverse health effects caused by exposure to these chemicals (e.g. bisphenol A). In 2011, the European Commission adopted a new regulation on the use of chemicals in plastics intended to come into contact with food. However, to this day, no EU regulation exists on chemicals used in other types of food contact materials (FCM). Consequently, non-plastic FCM are only covered by national legislation or by the general recommendations of the Council of Europe, containing ‘inventory lists’ of additives, monomers, solvents and other compounds that might be present in non-plastic FCM. Since no (recent) safety evaluation has been carried out for over 5000 substances present in these inventory lists, identification of substances requiring further safety data is urgently needed. The current study aims to develop a strategy to assign priority to substances used in printed paper and board. First, information on substances present in the inventory lists of the Council of Europe or from national legislation was assembled in a database. In a second step, their genotoxic potential was evaluated in silico using multiple (Q)SAR models (Toxtree, Derek Nexus™, VEGA Consensus model). An applicability domain assessment was performed to ensure fitting of the test compounds in the models applied. Based on the outcome of the in silico evaluation, substances containing a structural alert for genotoxicity were selected for further more in depth study, combining extensive literature review with in vitro genotoxicity testing.

Background: Anemia is more often seen in older patients. As the mean age of hip fracture patients is rising, anemia is common in this population. Allogeneic blood transfusion (ABT) and anemia have been pointed out as possible risk factors for poorer outcome in hip fracture patients. Methods. In the timeframe 2005-2010, 1262 admissions for surgical treatment of a hip fracture in patients aged 65 years and older were recorded. Registration was prospective from 2008 on. Anemic and non-anemic patients (based on hemoglobin level at admission) were compared regarding clinical characteristics, mortality, delirium incidence, LOS, discharge to a nursing home and the 90-day readmission rate. Receiving an ABT, age, gender, ASA classification, type of fracture and anesthesia were used as possible confounders in multivariable regression analysis. Results: The prevalence of anemia and the rate of ABT both were 42.5%. Anemic patients were more likely to be older and men and had more often a trochanteric fracture, a higher ASA score and received more often an ABT. In univariate analysis, the 3- and 12-month mortality rate, delirium incidence and discharge to a nursing home rate were significantly worse in preoperatively anemic patients. In multivariable regression analysis, anemia at admission was a significant risk factor for discharge to a nursing home and readmission < 90 days, but not for mortality. Indication for ABT, age and ASA classification were independent risk factors for mortality at all moments, only the mortality rate for the 3-12 month interval was not influenced by ABT. An indication for an ABT was the largest negative contributor to a longer LOS (OR 2.26, 95% CI 1.73-2.94) and the second largest for delirium (OR 1.67, 95% CI 1.28-2.20). Conclusions: This study has demonstrated that anemia at admission and postoperative anemia needing an ABT (PANT) were independent risk factors for worse outcome in hip fracture patients. In multivariable regression analysis, anemia

info:eu-repo/semantics/published

info:eu-repo/semantics/published

info:eu-repo/semantics/published

info:eu-repo/semantics/published

info:eu-repo/semantics/published

info:eu-repo/semantics/published

info:eu-repo/semantics/published

The objective of this study was to test the value of the concept of the net commercial value of standing timber in predicting the impact of logging activities on forest-cover modifications. A study area was selected in the East province of Cameroon which contains major primary forests and which contributes strongly to national timber production. A Geographic information System containing ecological and economic variables was used in combination with remote sensing data to define the net commercial value of standing timber in the East province. Taking account of the potential commercial value of standing timber improves our understanding of the spatial determinants of logging activities and of the resulting forest-cover modifications. The occurrence of logging-induced forest-cover modifications increases with the value of forest rent in one of the study sites, half of the very high rent areas have already been logged. In that site, therefore, it is mostly the low rent or marginal forest areas that remain unlogged. This was not the case, however, throughout the study area as shown by the observations at another site. (C) 2001 Academic Press.

The objective of this study is to better understand the complexity of deforestation processes in southern Cameroon by testing a multivariate, spatial model of land-cover change trajectories associated with deforestation. The spatial model integrates a spectrum of independent variables that characterize land rent on a spatially explicit basis. The use of a time series of high-spatial-resolution remote sensing images (Landsat MSS and SPOT XS), spanning two decades, allows a thorough validation of spatial projections of future deforestation. Remote sensing observations reveal a continuous trend of forest clearing and forest degradation in southern regions of Cameroon, but with a highly fluctuating rate. A significant proportion of the areas subject to a land-cover conversion experienced other changes in the following years. The study also demonstrates that modeling land-cover change trajectories over several observation years allows a better projection of areas with a high probability of change in land-cover than projecting such areas on the basis of observations from the previous time period alone. Statistical results suggest that, in our southern Cameroon study area, roads mostly increased the accessibility of the forest for migrants rather than providing incentives for a transformation of local subsistence agriculture into market-oriented farming systems. The spacial model developed in this study allows simulations of likely impacts of human actions, leading to a transformation of the landscape (e.g., road projects) on key landscape attributes (e.g., biodiversity). Currently, several road projects or major logging concessions exist in southern Cameroon.

Relationships between large-scale patterns of biodiversity and ecoclimatic variability were examined using distributions of 789 Andean birds; recorded in 15' x 15' grid cells, and interannual differences in Normalized Difference Vegetation Index and Brightness Surface Temperature, calculated month by month and resampled to 15' cells. Following the east Andean treeline from 1 degrees N to 18 degrees S; there is no evidence of a latitudinal gradient in species richness, but a considerable local variation reflecting the habitat complexity in individual cells. The mean endemism (inverse range-size for all species present in a given cell) shows well marked peaks. Pairwise comparisons of 'peaks' and adjacent 'lows' of endemism provide strong evidence for linking peaks of endemism with local ecoclimatic stability. The most important single factor responsible for this correlation could be orographic moderation of the impacts a south polar winds. Presently manifested as occasional winter freezes in the southern part of the tropical zone, these winds may have been a major determinant of vegetational changes during Pleistocene glacial periods. The correlations suggest that most endemics are relict populations which survived periods of global climatic change in places where these impacts were moderated. It is suggested that, by retaining relict populations, these places play a significant role in the recruitment to the regional species pool. The stable places were also centres of Andean cultures and have dense human populations. The current conservation strategy of reserving areas with few people therefore needs to be supplemented with actions to secure sustainable landuse in certain densely populated areas.

We present the recent Fermilab calculations of the masses of the light quarks, using tadpole-improved Sheikholeslami-Wohlert (SW) quarks. Various sources of systematic errors are studied. Our final result for the average light quark mass in the quenched approximation evaluated in the $\bar{MS}$ scheme is $\bar{m}_q(\mu=2 GeV;n_f=0)= (m_u+m_d)/2=3.6 \pm 0.6 MeV$., Comment: 3 pgs. 3 figures. espcrc2.sty included. Talk presented at LATTICE96(phenomenology)

We present the recent Fermilab calculations of the masses of the light quarks, using tadpole-improved Sheikholeslami-Wohlert (SW) quarks. Various sources of systematic errors are studied. Our final result for the average light quark mass in the quenched approximation evaluated in the $\bar{MS}$ scheme is $\bar{m}_q(\mu=2 GeV;n_f=0)= (m_u+m_d)/2=3.6 \pm 0.6 MeV$., Comment: 3 pgs. 3 figures. espcrc2.sty included. Talk presented at LATTICE96(phenomenology)

We present the recent Fermilab calculations of the masses of the light quarks, using tadpole-improved Sheikholeslami-Wohlert (SW) quarks. Various sources of systematic errors are studied. Our final result for the average light quark mass in the quenched approximation evaluated in the $\bar{MS}$ scheme is $\bar{m}_q(\mu=2 GeV;n_f=0)= (m_u+m_d)/2=3.6 \pm 0.6 MeV$., Comment: 3 pgs. 3 figures. espcrc2.sty included. Talk presented at LATTICE96(phenomenology)

We report on the status of the determination of the heavy quark masses from our calculation of the quarkonia spectra. All sources of systematic errors that enter the quark mass determination are accounted for. We explicitly keep $ma \neq 0$ in the perturbative calculation relating the bare lattice mass to a renormalized mass. Our results are still preliminary., Comment: 3 pages, uuencoded postscript file, to appear in the proceedings of Lattice'94, Bielefeld, Germany, Sep. 27 - Oct. 1, 1994.

We report on the status of the determination of the heavy quark masses from our calculation of the quarkonia spectra. All sources of systematic errors that enter the quark mass determination are accounted for. We explicitly keep $ma \neq 0$ in the perturbative calculation relating the bare lattice mass to a renormalized mass. Our results are still preliminary., Comment: 3 pages, uuencoded postscript file, to appear in the proceedings of Lattice'94, Bielefeld, Germany, Sep. 27 - Oct. 1, 1994.

We report on the status of the determination of the heavy quark masses from our calculation of the quarkonia spectra. All sources of systematic errors that enter the quark mass determination are accounted for. We explicitly keep $ma \neq 0$ in the perturbative calculation relating the bare lattice mass to a renormalized mass. Our results are still preliminary., Comment: 3 pages, uuencoded postscript file, to appear in the proceedings of Lattice'94, Bielefeld, Germany, Sep. 27 - Oct. 1, 1994.

The renormalization of a general action for massive lattice fermions is discussed. The analysis applies for all $m_q a$. Preliminary results for the self energy at one loop in perturbation theory are presented., Comment: 3 pages (you guessed it: to appear in Lattice '93), uuencoded PostScript file, FERMILAB-CONF-93/382-T and EFI 93-72. Regular PostScript file by anonymous ftp to fnth06.fnal.gov as pub/Fermilab-Pub/93.382

The renormalization of a general action for massive lattice fermions is discussed. The analysis applies for all $m_q a$. Preliminary results for the self energy at one loop in perturbation theory are presented., Comment: 3 pages (you guessed it: to appear in Lattice '93), uuencoded PostScript file, FERMILAB-CONF-93/382-T and EFI 93-72. Regular PostScript file by anonymous ftp to fnth06.fnal.gov as pub/Fermilab-Pub/93.382

The renormalization of a general action for massive lattice fermions is discussed. The analysis applies for all $m_q a$. Preliminary results for the self energy at one loop in perturbation theory are presented., Comment: 3 pages (you guessed it: to appear in Lattice '93), uuencoded PostScript file, FERMILAB-CONF-93/382-T and EFI 93-72. Regular PostScript file by anonymous ftp to fnth06.fnal.gov as pub/Fermilab-Pub/93.382