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Heat shock proteins (HSPs) consist of highly preserved stress proteins that are expressed in response to stress. Two studies were carried out to investigate whether HSP genes in hair follicles from beef calves can be suggested as indicators of heat stress (HS). In study 1, hair follicles were harvested from three male Hanwoo calves (aged 172.2 ± 7.20 days) on six dates over the period of 10 April to 9 August 2017. These days provided varying temperature–humidity indices (THIs). In study 2, 16 Hanwoo male calves (aged 169.6 ± 4.60 days, with a BW of 136.9 ± 6.23 kg) were maintained (4 calves per experiment) in environmentally controlled chambers. A completely randomized design with a 2 × 4 factorial arrangement involving two periods (thermoneutral: TN; HS) and four THI treatment groups (threshold: THI = 68 to 70; mild: THI = 74 to 76; moderate THI = 81 to 83; severe: THI = 88 to 90). The calves in the different group were subjected to ambient temperature (22°C) for 7 days (TN) and subsequently to the temperature and humidity corresponding to the target THI level for 21 days (HS). Every three days (at 1400 h) during both the TN and HS periods, the heart rate (HR) and rectal temperature (RT) of each individual were measured, and hair follicles were subsequently collected from the tails of each individual. In study 1, the high variation (P < 0.0001) in THI indicated that the external environment influenced the HS to different extents. The expression levels of the HSP70 and HSP90 genes at the high-THI level were higher (P = 0.0120, P = 0.0002) than those at the low-THI level. In study 2, no differences in the THI (P = 0.2638), HR (P = 0.2181) or RT (P = 0.3846) were found among the groups during the TN period, whereas differences in these indices (P < 0.0001, P < 0.0001 and P < 0.0001, respectively) were observed during the HS period. The expression levels of the HSP70 (P = 0.0010, moderate; P = 0.0065, severe) and HSP90 (P = 0.0040, severe) genes were increased after rapid exposure to heat-stress conditions (moderate and severe levels). We conclude that HSP gene expression in hair follicles provides precise and accurate data for evaluating HS and can be considered a novel indicator of HS in Hanwoo calves maintained in both external and climatic chambers.
The practice of foodborne illness outbreak investigations has evolved, shifting away from large-scale community case-control studies towards more focused case exposure assessments and sub-cluster investigations to identify contaminated food sources. Criteria to include or exclude cases are established to increase the efficiency of epidemiological analyses and traceback activities, but these criteria can also affect the investigator's ability to implicate a suspected food vehicle. A 2010 outbreak of Salmonella ser. Hvittingfoss infections associated with a chain of quick-service restaurants (Chain A) provided a useful case study on the impact of exclusion criteria on the ability to identify a food vehicle. In the original investigation, a case-control study of restaurant-associated cases and well meal companions was conducted at the ingredient level to identify a suspected food vehicle; however, 21% of cases and 22% of well meal companions were excluded for eating at Chain A restaurants more than once during the outbreak. The objective of this study was to explore how this decision affected the results of the outbreak investigation.
UK Biobank is a well-characterised cohort of over 500 000 participants including genetics, environmental data and imaging. An online mental health questionnaire was designed for UK Biobank participants to expand its potential.
Describe the development, implementation and results of this questionnaire.
An expert working group designed the questionnaire, using established measures where possible, and consulting a patient group. Operational criteria were agreed for defining likely disorder and risk states, including lifetime depression, mania/hypomania, generalised anxiety disorder, unusual experiences and self-harm, and current post-traumatic stress and hazardous/harmful alcohol use.
A total of 157 366 completed online questionnaires were available by August 2017. Participants were aged 45–82 (53% were ≥65 years) and 57% women. Comparison of self-reported diagnosed mental disorder with a contemporary study shows a similar prevalence, despite respondents being of higher average socioeconomic status. Lifetime depression was a common finding, with 24% (37 434) of participants meeting criteria and current hazardous/harmful alcohol use criteria were met by 21% (32 602), whereas other criteria were met by less than 8% of the participants. There was extensive comorbidity among the syndromes. Mental disorders were associated with a high neuroticism score, adverse life events and long-term illness; addiction and bipolar affective disorder in particular were associated with measures of deprivation.
The UK Biobank questionnaire represents a very large mental health survey in itself, and the results presented here show high face validity, although caution is needed because of selection bias. Built into UK Biobank, these data intersect with other health data to offer unparalleled potential for crosscutting biomedical research involving mental health.
To analyse the results of treatment for nasolabial cysts according to whether an intraoral sublabial or endoscopic transnasal approach was used, and to determine the recent surgical trend in our hospital.
Twenty-four patients with a histopathologically and radiologically confirmed nasolabial cyst between January 2010 and December 2017 were enrolled in this study.
Nasolabial cysts were predominant in females (91.7 per cent) and on the left side (54.2 per cent). Treatment involved an intraoral sublabial approach in 12 cases (48.0 per cent) and a transnasal endoscopic approach in 13 cases (52.0 per cent). In 13 cases (52.0 per cent) surgery was performed under local anaesthesia, while in 12 cases (48.0 per cent) it was conducted under general anaesthesia. The most common post-operative complications were numbness of the upper lip or teeth (n = 9, 36.0 per cent). Only one patient (4.0 per cent), who underwent a transnasal endoscopic approach, experienced a reoccurrence.
Surgical resection through an intraoral sublabial or transnasal endoscopic approach is the best treatment for a nasolabial cyst, showing very good results and a low recurrence rate. The recent surgical trend in our hospital is to treat nasolabial cysts using a transnasal endoscopic approach under local anaesthesia.
Post-traumatic stress disorder (PTSD) is a serious mental disorder that develops in some individuals following exposure to severe psychological stressors. In this chapter, we provide an overview of the conceptual issues, specific methods, and practical considerations in evidence-based assessment of PTSD. First, we outline the conceptual issues and practical components of a comprehensive assessment of PTSD. Second, we provide an overview of the most widely used self-rated and clinician-rated measures of trauma exposure and PTSD, comorbid disorders, and response bias. Third, we discuss cultural considerations in assessing PTSD. Fourth, we offer practical guidelines for conducting a clinically sensitive assessment of PTSD, highlighting some of the unique considerations in engaging trauma survivors in the assessment process and optimizing the information obtained. Last, we briefly summarize conceptual considerations and specific measures for other trauma- and stressor-related disorders.
Low rates of bystander cardiopulmonary resuscitation (CPR) were identified as a shortcoming in the “chain of survival” for out-of-hospital cardiac arrest (OHCA) care in the Korean city of Ansan. This study sought to evaluate the effect of an initiative to increase bystander CPR and quality of out-of-hospital resuscitation on outcome from OHCA. The post-intervention data were used to determine the next quality improvement (QI) target as part of the “Plan-Do-Study-Act” (PDSA) model for QI.
The study hypothesis was that bystander CPR, return of spontaneous circulation (ROSC), and survival to discharge after OHCA would increase in the post-intervention period.
This was a retrospective pre/post study. The data from the pre-intervention period were abstracted from 2008–2011 and the post-intervention period from 2012–2013. The effect of the intervention on the odds of ROSC and survival to hospital discharge was determined using a generalized estimating equation to account for confounders and the effect of clustering within medical centers. The analysis was then used to identify other factors associated with outcomes to determine the next targets for intervention in the chain of survival for cardiac arrest in this community.
Rates of documented bystander CPR increased from 13% in the pre-intervention period to 37% in the post-intervention period. The overall rate of ROSC decreased from 18.4% to 14.3% (risk difference −4.1%; 95% CI, −7.1%–1.0%), whereas survival to hospital discharge increased from 3.9% to 5.0% (risk difference 1.1%; 95% CI, −1.8%–3.8%), and survival with good neurologic outcome increased from 0.8% to 1.6% (risk difference 0.8%; 95% CI, −0.8%–2.4%). In multivariable analyses, there was no association between the intervention and the rate of ROSC or survival to hospital discharge. The designated level of the treating hospital was a significant predictor of both survival and ROSC.
In this case study, there were no observed improvements in outcomes from OHCA after the targeted intervention to improve out-of-hospital CPR. However, utilizing the PDSA model for QI, the designated level of the treating hospital was found to be a significant predictor of survival in the post-period, identifying the next target for intervention.
The Minnesota Center for Twin and Family Research (MCTFR) comprises multiple longitudinal, community-representative investigations of twin and adoptive families that focus on psychological adjustment, personality, cognitive ability and brain function, with a special emphasis on substance use and related psychopathology. The MCTFR includes the Minnesota Twin Registry (MTR), a cohort of twins who have completed assessments in middle and older adulthood; the Minnesota Twin Family Study (MTFS) of twins assessed from childhood and adolescence into middle adulthood; the Enrichment Study (ES) of twins oversampled for high risk for substance-use disorders assessed from childhood into young adulthood; the Adolescent Brain (AdBrain) study, a neuroimaging study of adolescent twins; and the Siblings Interaction and Behavior Study (SIBS), a study of adoptive and nonadoptive families assessed from adolescence into young adulthood. Here we provide a brief overview of key features of these established studies and describe new MCTFR investigations that follow up and expand upon existing studies or recruit and assess new samples, including the MTR Study of Relationships, Personality, and Health (MTR-RPH); the Colorado-Minnesota (COMN) Marijuana Study; the Adolescent Brain Cognitive Development (ABCD) study; the Colorado Online Twins (CoTwins) study and the Children of Twins (CoT) study.
To analyse how the auditory brainstem response changes in patients with sudden sensorineural hearing loss.
Data were collected via retrospective medical chart review.
Forty-three patients were included in this study. The mean latency of auditory brainstem response wave 1 was significantly longer for the affected side than for the unaffected side (p = 0.003). The mean latency of auditory brainstem response wave 1 was significantly shorter, and the mean amplitude of auditory brainstem response wave 1 was significantly larger, in the good response group compared to the poor response group. In forward conditional logistic regression analysis, auditory brainstem response wave 1 latency was an independent predictor of a good response (odds ratio = 34.37, 95 per cent confidence interval = 1.56–757.15, p = 0.025).
In patients with sudden sensorineural hearing loss, the latency of wave 1 of the auditory brainstem response was significantly increased and was related to prognosis.
We examine the origin of very-large-scale motions (VLSMs) in fully developed turbulent pipe flow at friction Reynolds number,
, using data from a direct numerical simulation. The VLSMs and the packet-like large-scale motions (LSMs) found in this study are very similar to those found in earlier studies. Three-dimensional time-evolving instantaneous fields show that one component of the process leading to the large streamwise length of VLSMs is the concatenation of adjacent streamwise LSMs caused by the continuous elongation of LSMs due to the strain component of the mean shear. Spatial organization patterns of the VLSMs and LSMs and their properties are studied by separating auto-correlation of the streamwise velocity fluctuations into the components of the VLSM and the LSM defined by low-pass/high-pass filtering in the streamwise direction. The structures of the two-point spatial correlations of the streamwise velocity component of the VLSMs and the LSMs in the streamwise-azimuthal plane are characterized by multiple maxima and complex patterns that beg explanation in terms of patterned coherent arrangements of the LSMs. Using proper orthogonal decomposition (POD), it is found that the X-shape correlation pattern of the VLSMs results from the superposition of very long helically inclined structures and streamwise-aligned structures. Further explanation of the patterns in the correlations of the VLSMs and LSMs is provided through the study of synthetically constructed arrangements of simple hairpin packet models of the LSM. Head-to-tail alignment of the model packets along streamwise and helical directions suggested by the eigenvalues of the POD creates a pair of long roll-cells centred above the logarithmic layer, and bracketing the LSMs. These roll-cells are pure kinematic consequences of the induction within the LSM packets, but they may also serve to organize smaller packets.
Chapter 4 argues that the Franklin’s performance serves as the dialectical synthesis of the views on value of the preceding performances, encompassing the wondrous renewal of the Squire, the amoral instrumentalism of the Merchant, and the meta-value of the Clerk. In this way, the Franklin’s performance presents a sober, disenchanted, but nonetheless ultimately affirmative meditation on the creative power of fiction - one that recognizes fiction’s instrumental value but insists that a paradoxically knowing mystification of this instrumentality can be the basis for a practicable ethics for living in a fallen world. To pursue this argument, the chapter performs a close reading of the Squire-Franklin link (taking into account the bearing of manuscript evidence), examines key aspects of the tale’s prologue and narrative, and considers the Franklin’s portrait in respect to the social status of franklins in Chaucer’s day. It concludes that the performance formulates a commitment to literary value that not only transcends the vulnerabilities of the preceding tales, but is also precisely the literary value that someone socially situated like Chaucer is best positioned to create.
Chapter 1 argues that the Clerk’s performance, like Chaucer’s earlier House of Fame, presents an array of different and even contradictory conceptions of literary value in order to give Chaucer’s fiction the distinctive meta-value of standing above any one commitment to literary value, playfully and provocatively assessing competing options, and thereby positioning the implied author as a master of the literary game. For the House of Fame this sort of meta-value serves the purpose of imagining the social identity of customs controller as a legitimate and distinctive locus for poetic composition. In the Clerk’s performance Chaucer imagines the university student as a normative masculine occupation for which meta-axiology is an end in itself, and thereby gives his earlier position a more authoritative and traditional institutional home. To pursue this argument, the chapter considers the House of Fame; select features of the Clerk’s prologue, tale, and epilogue, for the tale focusing on specific wording in light of its Petrarchan source; and the Clerk’s portrait, placing it against the backdrop of what we know about the normative function of the university in Chaucer’s day.
After presenting book’s justification, the introduction articulates its central argument: that the four-tale sequence of Clerk, Merchant, Squire, and Franklin enacts a dynamically unfolding, conflicted meditation on how literary value may be construed in a way that justifies the time, energy, and expense devoted to the writing of fiction - a justification made in respect to other activities pertaining to other values, especially to economic value in the sense of making a living. The introduction then considers the metacritical stakes and implications of this argument along the methodological dimension of the bearing of manuscript evidence on the principles of Chaucer interpretation and the conceptual dimension of the problem literary value. The former consideration reviews the manuscript basis for the book’s claim about the four-tale sequence; the latter consideration indicates theoretical debts (to, e.g., Bruno Latour and Georg Simmel) and introduces several key terms used throughout the book (the most important: literary axiology, axiological person, and axiological logic), explaining the relation of these terms to more traditional ones of Chaucer criticism.
Chapter 2 argues that the positioning of the Merchant’s performance as an answer to the Clerk’s stages a stern critique of the naïve escapism of the poet-student occupation as the Clerk’s performance imagines it. In this view, the Clerk’s meta-value is an attempt to avoid confronting the true nature of value in the sublunary realm: the material desires of flesh-and-blood individuals. According to the Merchant’s performance, all discourse is a self-interested instrument of these desires. Yet the chapter also argues that this grim position is not one voiced by a bitter man far removed from Chaucer, but rather that the tale is told with the very narratorial wit and playfulness most characteristic of Chaucer’s fiction, whether in his first-person voice or otherwise. For this reason, the Merchant’s dialectical negation of the Clerk’s notion of literary value represents at once Chaucer’s skepticism about the value of his own craft and his reveling in his mastery over it. To pursue this argument, the chapter performs a close reading of the Merchant’s Prologue, examines key moments in the Merchant’s Tale, and considers the Merchant’s portrait in its historical context.