关键词： obesity   postprandial lipemia   postprandial insulinemia   avocado   trout   alternative foods   healthy nutrients  

摘要： Obesity is one of the major health problems worldwide. Following healthy dietary patterns can be difficult in some countries due to the lack of availability of certain foods;thus, alternative foods are needed. Our aim was to evaluate the effect of a dietary pattern consisting of fruit, avocado, whole grains, and trout (FAWGT) on postprandial insulinemia and lipemia in obese Colombian subjects. A randomized controlled crossover study was conducted, in which 44 subjects with BMI >= 30 kg/m(2) followed either a FAWGT diet or a diet high in saturated fat and rich in processed carbohydrates. Levels of lipids and carbohydrates were measured during the postprandial state. The FAWGT diet reduced fasting insulin, VLDL, and HOMA-IR after 8 weeks (p < 0.05), while there was a lower postprandial increase in TG, VLDL, and insulin levels after both acute and chronic intake of FAWGT diet (p < 0.05). The intake of FAWGT-diet was characterized by high consumption of foods rich in fiber, MUFAs, and vitamins C and E (p < 0.05). The consumption of a diet composed of fruit, avocado, whole grains, and trout has emerged as a valid alternative to the foods included in other heart-healthy diets since it improves postprandial lipemia and insulinemia in obese people and has similar beneficial effects to these healthy models.

关键词： Adsorption   Lignocellulosic biomass   Statistical analysis   Dyes   Eucalyptus sawdust  

摘要： This paper describes the decoloration potential of a low-cost natural adsorbent, eucalyptus sawdust (ES), for rhodamine B (RhB) removal. Fourier-transform infrared spectroscopy analysis of the adsorbent revealed the presence of characteristic groups of cellulose, hemicellulose, and lignin. Scanning electron microscopy images showed that the surface of ES is heterogeneous and irregular. Point of zero charge studies revealed a negatively charged surface, which is favorable for RhB adsorption. A 23 full factorial central composite rotatable design was used to optimize dye removal. The optimal conditions were found to be biomass dosage of 0.49%, particle size of 0.44 mm, and unadjusted pH (4.0), providing high adsorption capacity and removal percentage. Adsorption studies were conducted using RhB concentrations of 50 and 100 mg L-1;under these conditions, the maximum adsorption was 90.1% and 92.8%, respectively, and the equilibrium was established in 420 min. Isothermal data were fitted to the Langmuir model, revealing a maximum adsorption capacity of 29.94 mg g(-1). The rate of adsorption followed second-order kinetics, indicating the occurrence of a chemical phenomenon and diffusion as the rate-governing step. Thermodynamic parameters showed that RhB adsorption is endothermic, spontaneous, and favorable.

摘要： Entrustable professional activities (EPAs) have been increasingly used as an assessment framework to formally capture the myriad ad hoc entrustment decisions that occur on a daily basis in clinical settings with learners present. Following the definition of Core EPAs for Entering Residency by the Association of American Medical Colleges in 2014, the American Board of Surgery (ABS) began to explore the utility of EPAs as a framework to support competency-based resident education within general surgery in 2016. As the complement of EPAs drafted for a specialty serve to define the core tasks of a professional within that discipline, initial efforts to define the entire scope of general surgery were fraught with difficulty as no commonly accepted definition of a general surgeon currently exists. Opting to prioritize a pilot of the EPA conceptual framework within surgical training rather than defining the entirety of the specialty, ABS leaders identified 5 EPAs that represent a core of general surgery with which to begin. This article details the process of choosing the initial set of EPAs and provides a roadmap for other disciplines interested in testing the feasibility of this assessment framework while garnering buy-in among the community of educators. Future steps, including implementation of the existing 5 EPAs beyond the initial pilot sites and drafting and implementation of the additional complement of EPAs, are also described.

关键词： Cellular senescence   Sarcopenia   Myotonic dystrophy type 1   Differential alternative splicing   Laser capture microdissection  

摘要： Progressive loss of muscle mass and function due to muscle fiber atrophy and loss in the elderly and chronically ill is now defined as sarcopenia. It is a major contributor to loss of independence, disability, need of long-term care as well as overall mortality. Sarcopenia is a heterogenous disease and underlying mechanisms are not completely understood. Here, we newly identified and used Tmem158, alongside Cdkn1a, as relevant senescence and denervation markers (SDMs), associated with muscle fiber atrophy. Subsequent application of laser capture microdissection (LCM) and RNA analyses revealed age- and disease-associated differences in gene expression and alternative splicing patterns in a rodent sarcopenia model. Of note, genes exhibiting such differential alternative splicing (DAS) are mainly involved in the contractile function of the muscle. Many of these splicing events are also found in a mouse model for myotonic dystrophy type 1 (DM1), underscoring the premature aging phenotype of this disease. We propose to add differential alternative splicing to the hallmarks of aging.

关键词： gnZVI   Sulfonamide antibiotic   Water remediation   Heterogeneous photo-Fenton process   Simulated sunlight  

摘要： In this work, the effectiveness of green zero-valent iron nanoparticles (gnZVIs) for the removal of the antibiotic sulfadiazine (SDZ) from water via adsorption and reduction was tested. Additionally, the effectiveness of this material as a catalyst for the Fenton and photo-Fenton processes was also investigated. This represents the first study concerning the use of gnZVIs for the degradation of a sulfonamide antibiotic. The results obtained indicate that gnZVIs were able to remove up to 58% of SDZ via adsorption and up to 69% via adsorption plus reduction using a SDZ/Fe3+ molar ratio of 1:61.6. Furthermore, gnZVIs showed strong effectiveness as a catalyst for the Fenton and photo-Fenton reactions, with complete SDZ removal in 8 h and 5 min, respectively, using a SDZ/ Fe3+/H2O2 molar ratio of 1:38.4:38.4. These results demonstrate that the use of gnZVIs constitutes an attractive and potential alternative technology for water remediation, reducing environmental impact and operational costs.

摘要： BACKGROUND Ryanodine receptor type 1 (RYR1) sequence variants are pathogenic for malignant hyperthermia. Variant carriers have a subtle increase in resting myoplasmic calcium concentration compared with nonaffected individuals, but whether this has metabolic effects in daily life is unknown. OBJECTIVES We analysed the potential effect of malignant hyperthermia-pathogenic RYR1 sequence variants on BMI as a single factor. Due to the heterogeneity of genetic variants predisposing to malignant hyperthermia, and to incomplete information about their regional distribution, we describe the prevalence of RYR1 variants in our population. DESIGN A retrospective cohort study. SETTING A single University hospital. PATIENTS Patients from malignant hyperthermia families with pathogenic RYR1 sequence variants were selected if BMI was available. OUTCOME MEASURES BMI values were compared amongst malignant hyperthermia susceptible (MHS) and malignant hyperthermia-negative individuals using hierarchical multivariable analyses adjusted for age and sex and considering family clustering. Variant prevalence was calculated. RESULTS The study included 281 individuals from 42 unrelated malignant hyperthermia families, 109 of whom were MHS and carriers of the familial RYR1 sequence variants. Median [IQR] BMI in MHS individuals with pathogenic RYR1 variants was 22.5 kg m(-2) [21.3 to 25.6 kg m(-2)]. In malignant hyperthermia-negative individuals without variants, median BMI was 23.4 kg m(-2) [21.0 to 26.3 kg m(-2)]. Using multivariable regression adjusted for age and sex, the mean difference was -0.73 (95% CI -1.51 to 0.05). No carrier of a pathogenic RYR1 sequence variant was found to have BMI higher than 30 kg m(-2). Only 10 RYR1 variants from the list of the European MH Group were found in our cohort, the most common being ***2168Met (39% of families), ***2336His (24%) and ***614Cys (12%). CONCLUSION The observed tendency towards lower BMI values in carriers of malignant hyperthermia-

关键词： Flap coverage   keystone flap   nasal defect   nasal reconstruction   plastic surgery  

摘要： Nasal defect coverage has some challenging aspects for plastic surgeons because of the midfacial location of the nose and the relationship between convexities and concavities of nasal subunits. The authors described our experience with performing keystone flap (KF) nasal reconstruction in accordance with the facial aesthetic subunit concept and demonstrated the expanding versatility of KFs in nasal reconstruction. Between January 2017 and February 2020, 15 patients (average age, 72.07 +/- 13.00 years, range: 38-88 years) underwent KF reconstruction for nasal defects. We performed KF reconstruction in accordance with the facial aesthetic subunit concept. Data, including the defect causes and locations, defect sizes, flap sites and sizes, types of KFs, flap survival, complications, and follow-up period for each patient were reviewed retrospectively. Cosmetic outcomes were evaluated by independent plastic surgeons and patients through satisfactory postoperative surveys. Sixteen defects occurred in 15 patients. The defect sizes ranged from 0.8 x 1 cm to 2.5 x 3 cm. The flap sizes ranged from 1.5 x 3.5 cm to 4 x 6 cm. All defects were successfully covered with KFs from adjacent subunits. All flaps survived without any postoperative complications. At the mean follow-up period of 8.33 +/- 2.92 months, the objective cosmetic outcomes were rated favorably, and the average subjective patient satisfaction score was 7.93 +/- 1.28 on a scale of 1 to 10. We suggest that using KF reconstruction in consideration of the facial aesthetic subunit concept can be a promising alternative modality for covering nasal defects with outstanding aesthetic outcomes.

摘要： BACKGROUND Early identification of patients at high risk of prolonged mechanical ventilation is important in critical care. Sarcopenia, the loss of muscle mass and function, has been reported to be associated with extended mechanical ventilation and prolonged ICU stay. Although ultrasound is noninvasive and widely used in critical care, there is no standard method of using it to assess sarcopenia. OBJECTIVES The study aims to investigate the relationship between outcomes of critically ill patients and the ratio of BMI to the thickness of rectus abdominis measured by a standardised ultrasound examination. DESIGN A retrospective cohort study. SETTING Surgical ICU of a tertiary referral hospital, from October 2017 to June 2018. The thickness of rectus abdominis (RA) was measured while performing extended focused assessment sonography for trauma. BMI was divided by the thickness of rectus abdominis over the upper abdomen to derive the BMI-RA thickness ratio. PATIENTS Sixteen male and 11 female patients admitted to ICU after major abdominal surgery. MAIN OUTCOME MEASURES The primary outcome was in-hospital mortality, and the secondary outcomes were durations of mechanical ventilation, ICU stay and hospital stay. The disease severity, serum albumin level and BMI-RA thickness ratio were also analysed. RESULTS Ultrasound measurement was easy to perform without adverse effects. The BMI-RA thickness ratio was significantly higher in nonsurvivors and was associated with ICU stay, hospital stay and duration of mechanical ventilation. Multivariable logistic regression showed that the BMI-RA thickness ratio was a predictor of in-hospital mortality. CONCLUSION The BMI-RA thickness ratio is related to the outcomes of patients transferred to ICU after major abdominal surgery. Measuring the thickness of rectus abdominis by ultrasound is well tolerated and easy to perform in surgical ICU. Larger prospective studies are required to confirm current findings.