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The disclosure of information to patients about diagnosis and prognosis and other aspects of care is still a matter of debate. We have conducted a study in advanced cancer patients about their experiences and preferences concerning this issue. A questionnaire was developed and completed during the first appointment in the outpatient clinic of an oncology centre's palliative care unit, before the patient had any contact with the staff of the unit. The study was conducted on a convenience sample of 47 patients. We found that 34 (72%) of those patients thought they had been informed of their diagnosis, most of them by the hospital doctor. However, not all stated the diagnosis in a manner clearly showing that they were aware of the nature of their disease. Most patients were with a family member when the diagnosis was disclosed, which is what the majority had preferred. Of the 13 uninformed patients, only one preferred to remain uninformed. Most patients (89%) participated in decisions concerning treatment, although only 68% thought they should have participated. Some 39 patients (83%) were informed that they were being referred to the palliative care unit, but surprisingly only eight had received an explanation of the unit's function. We concluded that, although most patients had been informed of their disease, there remains many problems, the most important of which, in our view, is the difference between the information provided and the patients' needs. [ABSTRACT FROM AUTHOR]

Deforestation and climate change may be helping Oropouche virus spread far beyond the Amazon Basin.

Protein meals from insects in combination with poultry by-product meal appear to be promising ingredients for replacing conventional proteins in the diets of carnivorous fish. The present study explored the effects on growth performance, hepatic enzymatic activity, and fillet physical and nutritional characteristics during a 66-day feeding trial performed on European seabass. A total of 3000 fish were distributed into three tanks, where the control group was fed with a commercial diet (CG) and a second group was fed in duplicate with the experimental diet (SSH) containing 10% Hermetia illucens larva meal, 30% poultry by-product meal, and <5.5 g/100 g of feed of marine origin proteins. All fish showed good growth performance. Glucose-6-phosphate dehydrogenase, aspartate aminotransferase, and 3-hydroxyacyl-CoA dehydrogenase activities were higher in the SSH group than in the CG group. The fillet fatty acid profile was largely unaffected by diet, except for a few fatty acids. Fish fed the SSH diet had a lower C22:1n-11 content than CG, thus suggesting an increased β-oxidation. The oxidative status of muscle lipids was not affected by the diet. In conclusion, the present study showed that European seabass can be successfully fed the SSH diet for two months in a commercial setting.

This study aimed to evaluate the effects of fish meal (FM) replacement with defatted Hermetia illucens larvae meal (HM) on the hematological profile, immune parameters, intestinal inflammatory status, and antioxidant response in gilthead seabream juveniles. Four diets were formulated, replacing FM with HM at 0%, 22%, 60%, and 100% levels, corresponding to an inclusion level of 15 (diet HM15), 30 (diet HM30), and 45% (diet HM45), respectively. Over 67 days, fish were fed these diets until apparent visual satiation. Results showed no significant differences in immune parameters or hematological profiles, except for a decrease in hemoglobin and hematocrit levels. In the liver, glucose-6-phosphate dehydrogenase and glutathione peroxidase decreased linearly with HM content, especially at 100% replacement. Glutathione reductase activity was also reduced with HM inclusion, being lower in fish fed diet HM30 compared to the control. Fish fed diet HM15 showed lower hepatic superoxide dismutase activity, while catalase activity and lipid peroxidation remained unaffected. In the intestine, antioxidant enzyme activity was not influenced by HM, but lipid peroxidation linearly decreased with HM inclusion, being lower in the HM30 diet compared to the control. The inclusion of HM reduced the expression of intestinal pro-inflammatory genes (interleukin-1β and cyclooxygenase-2) while the expression of transforming growth factor β was higher in fish fed diet HM30 compared to the control and HM45 diets. In conclusion, up to 45% dietary inclusion of HM showed no adverse effects, improving liver antioxidant status, reducing intestinal oxidative stress, and regulating inflammatory gene expression., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interests that could influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Although the benefits of oleic acid (OA) have been established in mammals, its effects on fish remain understudied. The aim of this study was to evaluate the antioxidant potential of OA in the liver, intestine, and muscle of European sea bass juveniles fed diets containing different lipid levels. For that purpose, six diets with 16 or 22% lipids and 0, 1, and 2% OA were formulated and triplicate groups of European sea bass juveniles (21.4 g) were fed with these experimental diets for 9 weeks. Increasing dietary lipid levels or OA supplementation did not affect antioxidant enzyme activity in the liver and muscle. Superoxide dismutase (SOD) activity in the intestine increased with both the dietary lipid and OA levels, while glucose 6 phosphate dehydrogenase (G6PDH) activity increased only with dietary OA supplementation. Reduced glutathione (GSH) and total glutathione (tGSH) content were higher in the liver and intestine of fish fed the low-lipid diets, while in the high-lipid diets it was lower in the muscle than in the liver and intestine. Present findings suggest that OA plays a role in the antioxidant defense mechanisms of European sea bass, particularly at the intestine level, but additional research is required to further assess the potential benefits of incorporating OA into the diets., Competing Interests: Declaration of Competing Interest The authors state that there is no conflict of interest., (Copyright © 2023. Published by Elsevier Inc.)

Evaluating the efficiency of surface treatments is a problem of paramount importance for the cork stopper industry. Generically, these treatments create coatings that aim to enhance the impermeability and lubrification of cork stoppers. Yet, current methods of surface analysis are typically time-consuming, destructive, have poor representativity or rely on indirect approaches. In this work, the use of a laser-induced breakdown spectroscopy (LIBS) imaging solution is explored for evaluating the presence of coating along the cylindrical surface and in depth. To test it, several cork stoppers with different shaped areas of untreated surface were analyzed by LIBS, making a rectangular grid of spots with multiple shots per spot, to try to identify the correspondent shape. Results show that this technique can detect the untreated area along with other features, such as leakage and holes, allowing for a high success rate of identification and for its performance at different depths, paving the way for future industry-grade quality control solutions with more complex surface analysis.

The present study was conducted to investigate the effects of dietary fish oil replacement with a mixture of vegetable oils and probiotic supplementation on plasma biochemical parameters, oxidative stress, and antioxidant ability of Seriola dumerili . Specimens with an initial weight of 175 g were used. Four feeds were formulated with 0% (FO-100), 75% (FO-25), and 100% (FO-0 and FO-0+ with the addition of Lactobacillus probiotics) substitution of fish oil with a mixture of linseed, sunflower, and palm oils. After 109 days, no significant differences were observed in the activity of antioxidant enzymes in the liver, foregut, and hindgut, only glucose-6-phosphate dehydrogenase activity in the liver was higher in the fish fed the FO-100 diet than in those fed the FO-0 diet. No significant differences were observed in the total, reduced, and oxidized glutathione and the oxidative stress index in the liver. In addition, lipid peroxidation in the liver and red muscle values were higher in the fish fed the FO-100 diet than in the fish fed the FO-0+ diet, however, the foregut of the fish fed the FO-100 diet presented lower values than that of the fish fed the FO replacement diet, with and without probiotics. There were significant differences in cholesterol levels in the FO-100 group; they were significantly higher than those observed with the fish diets without fish oil. To sum up, fish oil can be replaced by up to 25% with vegetable oils in diets for Seriola dumerili juveniles, but total fish oil substitution is not feasible because it causes poor survival. The inclusion of probiotics in the FO-0+ diet had no effects on the parameters measured.

Introduction  Opioids are the mainstay of pain management in critically ill patients. However, recent attention to their adverse effects in the intensive care unit (ICU) has led to the use of strategies that aim to reduce these side effects. Among these strategies, there are multimodal analgesia protocols, which prioritize pain management and employ a combination of different analgesics to spare excessive doses of opioids and sedatives in continuous infusion. Objective The objective of this study is to evaluate the impact of a multimodal analgesia protocol on clinical outcomes and consumption of sedatives and analgesics in two intensive care units. Methods  We conducted a single-center, quasi-experimental, retrospective, and prospective cohort study comparing clinical outcomes and consumption of sedatives and analgesics before and after the implementation of a multimodal pain management protocol in critically ill adult patients. We included 465 patients in 2017 (pre-intervention group) and 1508 between 2018 and 2020 (post-intervention group). Results In the analysis of the primary outcome, there was a significant reduction in mortality between 2017 and 2020 (27.7% - 21.7%, p=0.0134). There was no statistical difference in mechanical ventilation time or concerning the infection rate. Patients who received the multimodal analgesia protocol had a decrease of 24% regarding mean fentanyl intake and a progressive reduction in morphine milligram equivalents (MME) (8.4% - 19%). There was an increasing trend in the use of adjuvant analgesics and morphine in preemptive and therapeutic analgesia. Conclusion The implementation of a multimodal pain control protocol significantly reduced morbidity and mortality and the use of opioids in the ICU., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, de Souza et al.)