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Lausten Gould posted an update 6 months, 4 weeks ago
Serotonin (5-HT) has many important functions in both central and peripheral nervous systems. Although it has been demonstrated that manipulation of serotonin metabolism is possible in many species, there is limited information about l-tryptophan (TRP), a serotonin precursor, in cattle, and these provide conflicting results. Furthermore, there is no study evaluating how different patterns of intra-abomasal infusion of TRP impact circulating 5-HT. The objective of this study was to evaluate if intra-abomasal infusion patterns of TRP can affect circulating 5-HT and other metabolites from TRP metabolism in the plasma and serum and circulating glucose and insulin in cattle. Eight ruminally cannulated Holstein steers were used in a replicated 4 × 4 Latin square design. Each received intra-abomasal water infusion (control) or intra-abomasal TRP infusion (50 mg/kg BW) in 3 different patterns a pulse infusion once a day (pulse once), pulse infusion twice a day (pulse twice), or continuous infusion (continuous). For cs highest for pulse dose treatments. An acute supply of TRP in 1 or 2 daily doses increases serum 5-HT and increases circulating glucose and insulin in cattle. The TRP and kynurenine concentrations are similar in plasma and serum. However, the serum 5-HT concentration is more responsive to TRP administration than plasma.We described the clinical features and outcomes for 63 adult patients with acute myeloid leukemia (AML) with a translocation involving the 11q23 locus (MLL) who were treated at Memorial Sloan Kettering Cancer Center (MSK). The population included 40 female (63 %) and 23 male (37 %) patients, with a median age of 51 years old (range 18-82 years). Of the 31 patients who had had an antecedent malignancy, 14 (45 %) had had breast cancer or DCIS and 22 (71 %) had received anthracycline-based systemic chemotherapy. The translocation partner for the 11q23 rearrangement was identified in 60 of the 63 patients (95 %) studied. The distribution of translocation partners differed for those who had previously received cytotoxic chemotherapy. Most patients with therapy-related disease had a 9p22 or 19p13 partner, as compared to those with de novo disease (95 % vs. 68 %, p = 0.023). Of the 30 patients who received all therapy under observation, 15 (50 %) patients had de novo disease and 15 (50 %) had received antecedent chemotherapy. No significant difference in survival was observed between groups (p = 0.44). Twenty-two patients received induction as up-front therapy, of whom 11 (50 %) achieved CR / CRi. The achievement of CR / CRi with one course of induction was associated with improved OS, with a 6-month OS of 73 % as compared to 23 % for those who did not (p = 0.018). The achievement of CR / CRi with a single course of induction may be a marker of favorable survival in this subtype of high-risk AML. KEY POINT Response to a single induction was associated with favorable survival in this population.
Contracting non-government services to provide alcohol and other drug (AOD) treatment requires the specification of performance measures to ensure accountability for public funds. There is currently no standardised approach by funders to the measurement of performance of AOD treatment in Australia. Funding to non-government organisations (NGOs) is complex, with NGOs managing funding agreements from a range of sources that contain a large number of differing performance measures. This study aimed to assess performance measures used in contracts for NGO AOD treatment providers and how they align with best practice.
Performance measures contained in funding agreements for treatment providers were collected from a diverse sample of both funders (n=8) and treatment providers (n=20) resulting in more than 1,100 measures. The list of measures was synthesized to a finite, non-duplicative list (n=537). Measures were assessed by three raters against 11 criteria (for example, measurable and timely) documented as besent measures in contracts applied by funders to treatment services do not adhere to best practice. The development and implementation of new performance measures is required to inform AOD policy and accountability of public funds. Further, identifying more robust performance measures has the potential to lead to reduced reporting burden on service providers and better monitoring of service quality and outcomes.
Interferon-free, direct-acting antivirals (DAAs) for hepatitis C virus (HCV) offer much promise to achieve World Health Organization targets by 2030. However, impediments at the practitioner and health-system level will continue to obstruct the scale-up of DAAs worldwide unless identified and acted upon. Applying a diffusion of innovations framework, the aim of this study was to identify structural factors impacting practitioner experiences of managing HCV treatment.
In-depth, semi-structured, telephone interviews took place between September 2018 and April 2019 to investigate barriers and facilitators for engaging in HCV management and DAA therapy amongst general practitioners (GPs) who prescribe opioid agonist therapy and drug and alcohol specialists in Australia. Interviews were transcribed verbatim, de-identified, and coded, and data were analysed with iterative categorisation and thematic analysis using Everett Rogers’s diffusion of innovation framework.
amongst 30 participants (12 GPs, 18 drug and of DAA therapy are realised.
Reducing the global burden of HCV infection will not be possible without the widespread delivery of HCV treatment amongst practitioners. Practitioners and health workers require leadership and resources from health authorities so that the individual and population-level benefits of DAA therapy are realised.
Reduction of the maternal mortality ratio (MMR) to 12 per 100,000 live births by 2030 is a priority target in Georgia. This study aims to assess and classify MM in Georgia by direct and indirect causes of death from 2014 to 2017, using data from the national surveillance system and in accordance with internationally approved criteria.
In this secondary study, MM data was retrieved from the Maternal and Children’s Health Coordinating Committee and validated with data from the Vital Registry System and the Georgian Birth Registry. The study sample comprised 61 eligible MM cases. PF-07799933 Relevant information was transferred to case-report forms to review and classify MM cases by direct and indirect causes of maternal death.
The MMR during the study period was 26.7 per 100,000 live births. The proportion of direct causes of maternal death exceeded that of indirect causes, at 62% and 38%, respectively. The leading direct cause of maternal death was haemorrhage, while infection was the most frequent indirect cause. 52.