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Eggs attenuate postprandial hyperglycaemia (PPH), which transiently impairs vascular endothelial function (VEF). We hypothesised that co-ingestion of a glucose challenge with egg-based meals would protect against glucose-induced impairments in VEF by attenuating PPH and oxidative stress. A randomised, cross-over study was conducted in prediabetic men (n 20) who ingested isoenegertic meals (1674 kJ (400 kcal)) containing 100 g glucose (GLU), or 75 g glucose with 1·5 whole eggs (EGG), seven egg whites (WHITE) or two egg yolks (YOLK). At 30 min intervals for 3 h, brachial artery flow-mediated dilation (FMD), plasma glucose, insulin, cholecystokinin (CCK), lipids (total, LDL- and HDL-cholesterol; TAG), F2-isoprostanes normalised to arachidonic acid (F2-IsoPs/AA), and methylglyoxal were assessed. In GLU, FMD decreased at 30–60 min and returned to baseline levels by 90 min. GLU-mediated decreases in FMD were attenuated at 30–60 min in EGG and WHITE. Compared with GLU, FMDAUC was higher in EGG and WHITE only. Relative to baseline, glucose increased at 30–120 min in GLU and YOLK but only at 30–90 min in EGG and WHITE. GlucoseAUC and insulinAUC were also lower in EGG and WHITE only. However, CCKAUC was higher in EGG and WHITE compared with GLU. Compared with GLU, F2-IsoPs/AAAUC was lower in EGG and WHITE but unaffected by YOLK. Postprandial lipids and methylglyoxal did not differ between treatments. Thus, replacing a portion of a glucose challenge with whole eggs or egg whites, but not yolks, limits postprandial impairments in VEF by attenuating increases in glycaemia and lipid peroxidation.
Lexical stress is the contrast between strong and weak syllables within words. Ballard et al. (2012) examined the amount of stress contrastivity across adjacent syllables in word productions of typically developing three- to seven-year-olds and adults. Here, eight- to eleven-year-olds are compared with the adults from Ballard et al. using acoustic measurements of relative contrast in duration, peak intensity, and peak fundamental frequency of the vowels within the initial two syllables of each word. While eight- to eleven-year-olds are closer to adult-like stress contrastivity than three- to seven-year-olds, they are not yet adult-like in terms of the intensity contrast for words beginning with a weak syllable.
The association between mortality risk and use of antidepressants in people with dementia is unknown.
To describe the use of antidepressants in people with different dementia diagnoses and to explore mortality risk associated with use of antidepressants 3 years before a dementia diagnosis.
Study population included 20,050 memory clinic patients from Swedish Dementia Registry diagnosed with incident dementia. Data on antidepressants dispensed at the time of dementia diagnosis and during three-year period before dementia diagnosis was obtained from the Swedish Prescribed Drug Register. Cox regression models were used.
During a median follow-up of 2 years from dementia diagnosis, 25.8% of dementia patients died. A quarter (25.0%) of patients were on antidepressants at the time of dementia diagnosis while 21.6% used antidepressants at some point during a three-year period before a dementia diagnosis. Use of antidepressant treatment for 3 consecutive years before a dementia diagnosis was associated with a lower mortality risk for all dementia disorders (HR: 0.82, 95% CI: 0.72–0.94) and in Alzheimer's disease (HR: 0.61, 95% CI: 0.45–0.83). There were no significant associations between use of antidepressant treatment and mortality risk in other dementia diagnoses.
Antidepressant treatment is common among patients with dementia. Use of antidepressants during prodromal stages may reduce mortality in dementia and specifically in Alzheimer's disease.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
To develop latent classes of exposure to traumatic experiences before the age of 13 years in an urban community sample and to use these latent classes to predict the development of negative behavioral outcomes in adolescence and young adulthood.
A total of 1815 participants in an epidemiologically based, randomized field trial as children completed comprehensive psychiatric assessments as young adults. Reported experiences of nine traumatic experiences before age 13 years were used in a latent class analysis to create latent profiles of traumatic experiences. Latent classes were used to predict psychiatric outcomes at age ⩾13 years, criminal convictions, physical health problems and traumatic experiences reported in young adulthood.
Three latent classes of childhood traumatic experiences were supported by the data. One class (8% of sample), primarily female, was characterized by experiences of sexual assault and reported significantly higher rates of a range of psychiatric outcomes by young adulthood. Another class (8%), primarily male, was characterized by experiences of violence exposure and reported higher levels of antisocial personality disorder and post-traumatic stress. The final class (84%) reported low levels of childhood traumatic experiences. Parental psychopathology was related to membership in the sexual assault group.
Classes of childhood traumatic experiences predict specific psychiatric and behavioral outcomes in adolescence and young adulthood. The long-term adverse effects of childhood traumas are primarily concentrated in victims of sexual and non-sexual violence. Gender emerged as a key covariate in the classes of trauma exposure and outcomes.
The traditional metric for the efficiency of a numerical algorithm has been the number of arithmetic operations it performs. Technological trends have long been reducing the time to perform an arithmetic operation, so it is no longer the bottleneck in many algorithms; rather, communication, or moving data, is the bottleneck. This motivates us to seek algorithms that move as little data as possible, either between levels of a memory hierarchy or between parallel processors over a network. In this paper we summarize recent progress in three aspects of this problem. First we describe lower bounds on communication. Some of these generalize known lower bounds for dense classical (O(n3)) matrix multiplication to all direct methods of linear algebra, to sequential and parallel algorithms, and to dense and sparse matrices. We also present lower bounds for Strassen-like algorithms, and for iterative methods, in particular Krylov subspace methods applied to sparse matrices. Second, we compare these lower bounds to widely used versions of these algorithms, and note that these widely used algorithms usually communicate asymptotically more than is necessary. Third, we identify or invent new algorithms for most linear algebra problems that do attain these lower bounds, and demonstrate large speed-ups in theory and practice.
Whey protein intake reduces CVD risk, but little is known whether whey-derived bioactive peptides regulate vascular endothelial function (VEF). We determined the impact of a whey-derived extract (NOP-47) on VEF in individuals with an increased cardiovascular risk profile. Men and women with impaired brachial artery flow-mediated dilation (FMD) (n 21, age 55 (sem 1·3) years, BMI 27·8 (sem 0·6) kg/m2, FMD 3·7 (sem 0·4) %) completed a randomised, cross-over study to examine whether ingestion of NOP-47 (5 g) improves postprandial VEF. Brachial artery FMD, plasma amino acids, insulin, and endothelium-derived vasodilators and vasoconstrictors were measured for 2 h after ingestion of NOP-47 or placebo. Acute NOP-47 ingestion increased FMD at 30 min (4·6 (sem 0·5) %) and 120 min (5·1 (sem 0·5) %) post-ingestion (P< 0·05, time × trial interaction), and FMD responses at 120 min were significantly greater in the NOP-47 trial compared with placebo (4·3 (sem 0·5) %). Plasma amino acids increased at 30 min following NOP-47 ingestion (P< 0·05). Serum insulin increased at 15, 30 and 60 min (P< 0·001) following NOP-47 ingestion. No changes were observed between the trials for plasma NO∙ and prostacyclin metabolites or endothelin-1. Ingestion of a rapidly absorbed extract derived from whey protein improved endothelium-dependent dilation in older adults by a mechanism independent of changes in circulating vasoactive compounds. Future investigation is warranted in individuals at an increased CVD risk to further elucidate potential health benefits and the underlying mechanisms of extracts derived from whey.
To assess feeding practices of infants born to HIV-positive women in Dar es Salaam, Tanzania. These data then served as a proxy to evaluate the adequacy of current infant feeding counselling.
A cross-sectional survey of infant feeding behaviours.
Four clinics in greater Dar es Salaam in early 2008.
A total of 196 HIV-positive mothers of children aged 6–10 months recruited from HIV clinics.
Initiation of breast-feeding was reported by 95·4 % of survey participants. In the entire sample, 80·1 %, 34·2 % and 13·3 % of women reported exclusive breast-feeding (EBF) up to 2, 4 and 6 months, respectively. Median duration of EBF among women who ever breast-fed was 3 (interquartile range (IQR): 2·1, 4·0) months. Most non-breast-milk foods fed to infants were low in nutrient density. Complete cessation of breast-feeding occurred within 14 d of the introduction of non-breast-milk foods among 138 of the 187 children (73·8 %) who had ever received any breast milk. Of the 187 infants in the study who ever received breast milk, 19·4 % received neither human milk nor any replacement milks for 1 week or more (median duration of no milk was 14 (IQR: 7, 152) d).
Infant feeding practices among these HIV-positive mothers resulted in infants receiving far less breast milk and more mixed complementary feeds than recommended, thus placing them at greater risk of both malnutrition and HIV infection. An environment that better enables mothers to follow national guidelines is urgently needed. More intensive infant feeding counselling programmes would very likely increase rates of optimal infant feeding.
The majority of people with dementia develop behavioral and psychological symptoms of dementia (BPSD) at some point during their illness (Jeste et al., 2008). These symptoms, which are especially common among care home residents, are frequently distressing for the patients who experience them (Gilley et al., 2006; Jeste et al., 2008) and problematic for their professional and/or family caregivers. The starting point for our paper “Quality of life for people with dementia living in residential and nursing home care: the impact of performance on activities of daily living, behavioral and psychological symptoms, language skills, and psychotropic drugs” (Ballard et al., 2001) was to try and understand the impact of BPSD, function and language skills on quality of life in care home residents with dementia. Although there were frequent statements in previous work referring to the capacity of psychiatric and behavioral symptoms to reduce quality of life, we had been unable to identify any empirical evidence to support this clinical impression in a thorough literature review. The parallel validation of Dementia Care Mapping (DCM), predominantly a practice development tool, as an observational measure of well-being/quality of life (Kitwood and Bredin, 1997; Fossey et al., 2002) provided an excellent opportunity to examine this issue in a care home setting. The study focused on 209 people with dementia living in residential and nursing home care in north-east England in the U.K., who received a detailed assessment of BPSD, function and cognition. A DCM evaluation was completed for 112 of these individuals, providing a detailed observational measure of well-being, activities and social withdrawal as indices of quality of life over a six-hour daytime period. To our surprise, there was actually no association between well-being, social withdrawal or activities and BPSD. In contrast, there was a significant association between antipsychotic medication and reduced well-being, social withdrawal and activities respectively, even after controlling for the severity of behavioral disturbance. Using an arbitrary definition of “ill-being”, defined as a well-being score of less than zero, 5% of people not taking antipsychotics, 10% of people taking atypical antipsychotics and 22% of people taking typical antipsychotics were defined as having ill-being. Lower levels of functional ability were also associated with significantly lower well-being, less activities and more social withdrawal. At first this latter finding appears to be contrary to one of the central principles of DCM – namely, that the assessment should be independent of dementia severity. Although high levels of well-being and engagement are possible for people with severe dementia, this probably requires higher staff numbers and a workforce with more specialized skills in order to achieve this.
A microbiological investigation of Black infants suffering from severe acute summer gastroenteritis revealed enteropathogenic agents in 30 out of 37 patients (81%). Enterotoxigenic bacteria were isolated from 15 patients (41%). A total of 16 enterotoxigenic strains were isolated, comprising 9 enterotoxigenic Escherichia coli strains secreting labile and stable toxin on their own and in combination, and labile-toxin secreting strains of Klebsiella pneumoniae (4), Enterobacter cloacae (2) and Proteus vulgaris (1). In the case of the latter three species, however, 6 out of the 7 strains were isolated from patients who were excreting other enteric pathogens, whereas only 2 out of 9 enterotoxigenic E. coli patients had concomitant infections with other pathogens. No invasive bacteria were isolated except for 2 shigella strains. Salmonella and shigella strains were found in four patients. No correlation was found between the enteropathogenicity of E. coli and its serotype. Rotavirus was observed by negative staining electron microscopy in only two patients (6%) but using a reverse complement fixation test rotavirus antigen was detected in the stool of 17 out of 35 patients (49%). The low EM detection rate may well be due to the patients being admitted for treatment late in the course of their illness when the degree of viral shedding has decreased below EM detectability. No significant difference in clinical presentation was noted between the various aetiological agents. Only one patient was being solely breast-fed compared to 16% of control non-diarrhoeic infants. Evidence of malnutrition was noted in over half of our patients.
The NASA Discovery mission EPOXI, utilizing the Deep Impact flyby spacecraft, comprises two phases: EPOCh (Extrasolar Planet Observation and Characterization) and DIXI (Deep Impact eXtended Investigation). With EPOCh, we use the 30-cm high resolution visible imager to obtain ultraprecise photometric light curves of known transiting planet systems. We will analyze these data for evidence of additional planets, via transit timing variations or transits; for planetary moons or rings; for detection of secondary eclipses and the constraint of geometric planetary albedos; and for refinement of the system parameters. Over a period of four months, EPOCh observed four known transiting planet systems, with each system observed continuously for several weeks. Here we present an overview of EPOCh, including the spacecraft and science goals, and preliminary photometry results.
EPOXI (EPOCh + DIXI) is a NASA Discovery Program Mission of Opportunity using the Deep Impact flyby spacecraft. The EPOCh (Extrasolar Planet Observation and Characterization) Science Investigation will gather photometric time series of known transiting exoplanet systems from January through August 2008. Here we describe the steps in the photometric extraction of the time series and present preliminary results of the first four EPOCh targets.
The arrival in January 2001 in the south-west Ross Sea of two giant icebergs, C16 and B15A, subsequently had dramatic affects on two emperor penguin colonies. B15A collided with the north-west tongue of the Ross Ice Shelf at Cape Crozier, Ross Island, in the following months and destroyed the penguins' nesting habitat. The colony totally failed in 2001, and years after, with the icebergs still in place, exhibited reduced production that ranged from 0 to 40% of the 1201 chicks produced in 2000. At Beaufort Island, 70 km NW of Crozier, chick production declined to 6% of the 2000 count by 2004. Collisions with the Ross Ice Shelf at Cape Crozier caused incubating adults to be crushed, trapped in ravines, or to abandon the colony and, since 2001, to occupy poorer habitat. The icebergs separated Beaufort Island from the Ross Sea Polynya, formerly an easy route to feeding and wintering areas. This episode has provided a glimpse of events which have probably occurred infrequently since the West Antarctic Ice Sheet began to retreat 12 000 years ago. The results allow assessment of recovery rates for one colony decimated by both adult and chick mortality, and the other colony by adult abandonment and chick mortality.
To assess the risk of environmental and healthcare worker (HCW) contamination with vancomycin-resistant enterococci (VRE) during outpatient procedures performed on fecally continent patients currently colonized with VRE (cVRE) or previously colonized with VRE (pVRE).
Outpatient consultation and radiology rooms and the hemodialysis unit in a university teaching hospital.
Fecally continent cVRE and pVRE patients.
Both cVRE and pVRE patients attended standardized mock outpatient consultations and routine hemodialysis sessions in an area that had been thoroughly cleaned and microbiologically confirmed to be free of VRE contamination. After each session, the patient, environment, and participating HCW were tested for VRE contamination.
Fourteen cVRE patients participated in 49 mock outpatient consultation sessions and radiology sessions or 26 actual hemodialysis sessions, and 7 pVRE patients participated in 28 outpatient consultation sessions. Sessions with cVRE patients had higher rates of contamination of the environment (chair cultures were positive for VRE in 36% of outpatient consultation sessions, 58% of hemodialysis sessions; couch cultures were positive in 48% of outpatient consultation sessions, 42% of radiology sessions, and 45% of hemodialysis sessions), contamination of HCW gowns (gown cultures were positive in 20% of outpatient consultation sessions, 4% of radiology sessions, and 30% of hemodialysis sessions), and contamination of patients' own hands (hand cultures were positive in 36% of outpatient consultation sessions, 25% of radiology sessions, and 54% of hemodialysis sessions). Overall, contamination rates associated with pVRE patients attendance at outpatient consultations were 12% of those noted for cVRE patients (odds ratio, 0.10; 95% confidence interval, 0.03-0.42; P = .001).
Given the nature of the contamination risk posed by fecally continent cVRE patients undergoing outpatient procedures, infection control measures should focus on effective HCW and patient hand hygiene and chair and couch cleaning, to minimize transmission of VRE.
In a study designed to elucidate the factors that might differentially affect the well being and biology of Adélie penguins (Pygoscelis adeliae) that breed in colonies of different size, we investigated the predation rates on penguins by leopard seals (Hydrurga leptonyx) over a period of six years. The study colonies varied in size across the full range for this penguin species, contrasting with previous studies in which data were gathered only at very large colonies, and only in single years. The number of seals present varied directly with the amount of penguin traffic in the areas near the beach, where most predation takes place. Seals were present persistently only when penguin traffic exceeded about 250 penguins per hour. Predation rates also varied with penguin traffic in a curvilinear fashion, leveling off where traffic exceeded about 1200 penguins per hour. With respect to predation, it appears to be advantageous for Adélie penguins to nest in very small or very large colonies. At large colonies, the number of penguins moving to and from the colony ‘swamp’ the seals' predatory efforts, thus reducing the chances that an individual penguin will be taken. Small colonies are of little interest to the seals.
Ex-situ transmission electron microscopy (TEM) was performed on catalytically-grown multi-wall carbon nanotubes (MWCNTs), leading to the identification of two types of catalyst-nanotube wall interfaces – respectively characterized by a quasi-spherical, low aspect ratio particle closer to the nanotube root and by a tapered, high aspect ratio particle farther away from it. The nanotubes exhibit two distinct types of boundaries between crystalline domains with different orientations – twist and twin boundaries in correspondence with quasi-spherical particles and tilt boundaries in correspondence with the tapered particles. TEM evidence suggests that the domain boundaries maintain a rather steady position coupled to the catalytic particles, while the carbon atoms diffuse along the nanotube axis away from the particles. From these considerations, it is possible to conclude that the relative movement of the carbon atoms with respect to the dislocation lines comprising the nanotube domain boundary located at the catalyst-wall interface is a significant mechanism for nanotube crystal growth mainly driven by surface diffusion. The results are interpreted in light of the concurrence of base- and tip- growth for the catalytic synthesis of nanotubes dominated by surface diffusion.
The feasibility of determining metallic elements used as mordants or dyes with inorganic constituents was tested using inductively coupled plasma – mass spectrometry (ICP-MS). For this purpose, modern, historic and archaeological samples were investigated. Mordants containing copper, iron, tin, aluminium or uranium were successfully identified as well as an organic dye with a substitutional bromine.