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Anecdotal evidence suggests the use of bolus tube feeding is increasing in long term home enteral tube feed (HETF) patients. A cross-sectional survey to assess the prevalence of bolus tube feeding and to characterise these patients was undertaken. Dietitians from 10 centres across the UK collected data on all adult HETF patients on the dietetic caseload receiving bolus tube feeding, (n=604, 60% male, age 58years). Demographic data, reasons for tube and bolus feeding, tube and equipment types, feeding method and patients’ complete tube feeding regimens were recorded. Over a third of patients receiving HETF used bolus feeding (37%). Patients were long-term tube fed (4.1years tube feeding, 3.5years bolus tube feeding), living at home (71%) and sedentary (70%). The majority were head and neck cancer patients (22%) who were significantly more active (79%) and lived at home (97%), while those with cerebral palsy (12%) were typically younger (age 31years) but sedentary (94%). Most patients used bolus feeding as their sole feeding method (46%), because it was quick and easy to use, as a top up to oral diet or to mimic meal times. Importantly, oral nutritional supplements (ONS) were used for bolus feeding in 85% of patients, with 51% of these being compact-style ONS (2.4kcal/ml, 125ml). This survey shows that bolus tube feeding is common amongst UK HETF patients, is used by a wide variety of patient groups and can be adapted to meet the needs of a variety of patients, clinical conditions, nutritional requirements and lifestyles.
Granular flows occur in a wide range of situations of practical interest to industry, in our natural environment and in our everyday lives. This paper focuses on granular flow in the so-called inertial regime, when the rheology is independent of the very large particle stiffness. Such flows have been modelled with the
-rheology, which postulates that the bulk friction coefficient
(i.e. the ratio of the shear stress to the pressure) and the solids volume fraction
are functions of the inertial number
only. Although the
-rheology has been validated in steady state against both experiments and discrete particle simulations in several different geometries, it has recently been shown that this theory is mathematically ill-posed in time-dependent problems. As a direct result, computations using this rheology may blow up exponentially, with a growth rate that tends to infinity as the discretization length tends to zero, as explicitly demonstrated in this paper for the first time. Such catastrophic instability due to ill-posedness is a common issue when developing new mathematical models and implies that either some important physics is missing or the model has not been properly formulated. In this paper an alternative to the
-rheology that does not suffer from such defects is proposed. In the framework of compressible
-dependent rheology (CIDR), new constitutive laws for the inertial regime are introduced; these match the well-established
relations in the steady-state limit and at the same time are well-posed for all deformations and all packing densities. Time-dependent numerical solutions of the resultant equations are performed to demonstrate that the new inertial CIDR model leads to numerical convergence towards physically realistic solutions that are supported by discrete element method simulations.
A waterhemp [Amaranthus tuberculatus (Moq.) J. D. Sauer] biotype (designated as “NER”) collected from a soybean [Glycine max (L.) Merr.] production field in eastern Nebraska survived the POST application of fomesafen at the labeled rate. The objectives of this study were to (1) quantify the level of resistance to protoporphyrinogen oxidase (PPO) inhibitors (acifluorfen, fomesafen, and lactofen) applied POST, (2) determine the mechanism of PPO-inhibitor resistance in the NER biotype, (3) determine whether NER possessed multiple resistance to acetolactate synthase (ALS)-, 5-enolpyruvylshikimate-3-phosphate synthase (EPSPS)-, and photosystem II (PSII)-inhibiting herbicides, and (4) control NER with POST soybean herbicides. A whole-plant dose–response bioassay revealed that the NER biotype was 4- to 6-fold resistant to PPO-inhibiting herbicides depending on the known susceptible biotype (S1 or S2) used for comparison. A Kompetitive Allele Specific PCR (KASP™) assay was developed and performed for rapid and robust detection of the ΔG210 mutation (deletion of a codon) in the PPX2L gene. All samples of the NER biotype tested positive for the ΔG210 mutation. Dose–response bioassays confirmed that the NER biotype was resistant to three additional herbicide sites of action. Chlorimuron and imazethapyr, both ALS inhibitors, applied at 32X the labeled rate resulted in <80% reduction in the aboveground biomass of the NER biotype. The same biotype was 3- and 7-fold resistant to glyphosate (EPSPS inhibitor) and atrazine (PSII inhibitor), respectively. Glufosinate, 2,4-D choline plus glyphosate, and dicamba were the only soybean POST herbicides that controlled NER effectively (≥92% aboveground biomass reduction). Amaranthus tuberculatus is the first confirmed weed species in Nebraska to evolve resistance to four distinct herbicide sites of action, leaving no POST herbicide choice for effective control in glyphosate-resistant and conventional (non-transgenic) soybean.
Infants with prenatally diagnosed CHD are at high risk for adverse outcomes owing to multiple physiologic and psychosocial factors. Lack of immediate physical postnatal contact because of rapid initiation of medical therapy impairs maternal–infant bonding. On the basis of expected physiology, maternal–infant bonding may be safe for select cardiac diagnoses.
This is a single-centre study to assess safety of maternal–infant bonding in prenatal CHD.
In total, 157 fetuses with prenatally diagnosed CHD were reviewed. On the basis of cardiac diagnosis, 91 fetuses (58%) were prenatally approved for bonding and successfully bonded, 38 fetuses (24%) were prenatally approved but deemed not suitable for bonding at delivery, and 28 (18%) were not prenatally approved to bond. There were no complications attributable to bonding. Those who successfully bonded were larger in weight (3.26 versus 2.6 kg, p<0.001) and at later gestation (39 versus 38 weeks, p<0.001). Those unsuccessful at bonding were more likely to have been delivered via Caesarean section (74 versus 49%, p=0.011) and have additional non-cardiac diagnoses (53 versus 29%, p=0.014). There was no significant difference regarding the need for cardiac intervention before hospital discharge. Infants who bonded had shorter hospital (7 versus 26 days, p=0.02) and ICU lengths of stay (5 versus 23 days, p=0.002) and higher survival (98 versus 76%, p<0.001).
Fetal echocardiography combined with a structured bonding programme can permit mothers and infants with select types of CHD to successfully bond before ICU admission and intervention.
Cortical glutamatergic dysfunction is thought to be fundamental for psychosis development, and may lead to structural degeneration through excitotoxicity. Glutamate levels have been related to gray matter volume (GMV) alterations in people at ultra-high risk of psychosis, and we previously reported GMV changes in individuals with high schizotypy (HS), which refers to the expression of schizophrenia-like characteristics in healthy people. This study sought to examine whether GMV changes in HS subjects are related to glutamate levels.
We selected 22 healthy subjects with HS and 23 healthy subjects with low schizotypy (LS) based on their rating on a self-report questionnaire for psychotic-like experiences. Glutamate levels were measured in the bilateral anterior cingulate cortex (ACC) using proton magnetic resonance spectroscopy, and GMV was assessed using voxel-based morphometry.
Subjects with HS showed GMV decreases in the rolandic operculum/superior temporal gyrus (pFWE = 0.045). Significant increases in GMV were also detected in HS, in the precuneus (pFWE = 0.043), thereby replicating our previous finding in a separate cohort, as well as in the ACC (pFWE = 0.041). While the HS and LS groups did not differ in ACC glutamate levels, in HS subjects ACC glutamate was negatively correlated with ACC GMV (pFWE = 0.026). Such association was absent in LS.
Our study shows that GMV findings in schizotypy are related to glutamate levels, supporting the hypothesis that glutamatergic function may lead to structural changes associated with the expression of psychotic-like experiences.
Dietary polyunsaturated fatty acids (PUFA) are known to influence the fatty acid composition of immune and inflammatory cell membranes (Yaqoob et al, 1995). Changing the fatty acid composition and the n-6/n-3 PUFA ratio of cell membranes has been reported to have profound effects on immune cell functionality (Blok et al, 1996). Immune responses to Cooperia onchophara, a nematode parasite that infects calves, are usually slow to develop and inappropriate. The aim of this experiment was to establish the extent to which supplementation of pre-ruminant calves with an n-6 or n-3 PUFA source may influence ex-vivo lymphocyte response to an L3 C onchophara antigen.
Objectives: The aim of this study was to determine the presence and severity of potential cultural and language bias in widely used cognitive and other assessment instruments, using structural MRI measures of neurodegeneration as biomarkers of disease stage and severity. Methods: Hispanic (n=75) and White non-Hispanic (WNH) (n=90) subjects were classified as cognitively normal (CN), amnestic mild cognitive impairment (aMCI) and mild dementia. Performance on the culture-fair and educationally fair Fuld Object Memory Evaluation (FOME) and Clinical Dementia Rating Scale (CDR) between Hispanics and WNHs was equivalent, in each diagnostic group. Volumetric and visually rated measures of the hippocampus entorhinal cortex, and inferior lateral ventricles (ILV) were measured on structural MRI scans for all subjects. A series of analyses of covariance, controlling for age, depression, and education, were conducted to compare the level of neurodegeneration on these MRI measures between Hispanics and WNHs in each diagnostic group. Results: Among both Hispanics and WNH groups there was a progressive decrease in volume of the hippocampus and entorhinal cortex, and an increase in volume of the ILV (indicating increasing atrophy in the regions surrounding the ILV) from CN to aMCI to mild dementia. For equivalent levels of performance on the FOME and CDR, WNHs had greater levels of neurodegeneration than did Hispanic subjects. Conclusions: Atrophy in medial temporal regions was found to be greater among WNH than Hispanic diagnostic groups, despite the lack of statistical differences in cognitive performance between these two ethnic groups. Presumably, unmeasured factors result in better cognitive performance among WNH than Hispanics for a given level of neurodegeneration. (JINS, 2018, 24, 176–187)
In recent years considerable progress has been made in the continuum modelling of granular flows, in particular the
-rheology, which links the local viscosity in a flow to the strain rate and pressure through the non-dimensional inertial number
. This formulation greatly benefits from its similarity to the incompressible Navier–Stokes equations as it allows many existing numerical methods to be used. Unfortunately, this system of equations is ill posed when the inertial number is too high or too low. The consequence of ill posedness is that the growth rate of small perturbations tends to infinity in the high wavenumber limit. Due to this, numerical solutions are grid dependent and cannot be taken as being physically realistic. In this paper changes to the functional form of the
curve are considered, in order to maximise the range of well-posed inertial numbers, while preserving the overall structure of the equations. It is found that when the inertial number is low there exist curves for which the equations are guaranteed to be well posed. However when the inertial number is very large the equations are found to be ill posed regardless of the functional dependence of
. A new
curve, which is inspired by the analysis of the governing equations and by experimental data, is proposed here. In order to test this regularised rheology, transient granular flows on inclined planes are studied. It is found that simulations of flows, which show signs of ill posedness with unregularised models, are numerically stable and match key experimental observations when the regularised model is used. This paper details two-dimensional transient computations of decelerating flows where the inertial number tends to zero, high-speed flows that have large inertial numbers, and flows which develop into granular rollwaves. This is the first time that granular rollwaves have been simulated in two dimensions, which represents a major step towards the simulation of other complex granular flows.
Deposit formation on turbine hardware in propulsion turbine engines can occur in many arid regions globally. Characterising crystalline deposits on metallic substrates can aid in component resilience and health monitor algorithms during particle ingestion. This study has developed two statistical empirical models for prediction from acquired experimental data for the onset of deposits. The prediction models are for crystalline particulate (Arizona Road Test Dust) deposits on a flat rectangular Hastelloy-X test coupon. Particle impingement angles varied between 20° and 80° in experimental flow temperatures of 1,000–1,100°C. Averaged deposits are methodically quantified through normalised particle deposit tallies per area and percent coverage of the surface using microscopic imaging and image processing programs. Deposit accumulation is a quadratic function of both near-surface coupon temperature and coupon angle.
Terrestrial gastropods are problematical for radiocarbon (14C) measurement because they tend to incorporate carbon from ancient sources as a result of their dietary behavior. The 14C ecology of the pulmonate land snail, Helix melanostoma in Cyrenaica, northeastern Libya, was investigated as part of a wider study on the potential of using terrestrial mollusk shell for 14C dating of archaeological deposits. H. melanostoma was selected out of the species available in the region as it has the most predictable 14C ecology and also had a ubiquitous presence within the local archaeology. The ecological observations indicate that H. melanostoma has a very homogenous 14C ecology with consistent variations in F14C across sample sites controlled by availability of dietary vegetation. The majority of dated specimens from non-urbanized sample locations have only a small old-carbon effect, weighted mean of 476±48 14C yr, with between ~1% and 9% of dietary F14C from non-organic carbonate sources. Observed instabilities in the 14C ecology can all be attributed to the results of intense human activity not present before the Roman Period. Therefore, H. melanostoma and species with similar ecological behavior are suitable for 14C dating of archaeological and geological deposits with the use of a suitable offset.
Rapid weight gain in infancy and low levels of n-3 long chain polyunsaturated fatty acids (LCPUFA) at birth are associated with increased adiposity later in life. The association between placental LCPUFA delivery and weight gain in infancy is poorly understood. We sought to determine the relationships between maternal phenotype, placental fatty acid transporter expression and offspring growth patterns over the first 6 months. Placental tissue and cord blood were collected at term delivery from women with uncomplicated pregnancies. Offspring body composition measurements were recorded 1 day and 6 months after birth. Body mass index (BMI) z-scores were determined using World Health Organization 2006 reference data. Body phenotype patterns were compared among offspring who had an increase in BMI z-score and those who had a decrease. High skinfold thickness at birth and positive change in BMI z-scores during infancy were associated with low neonatal n-3 LCPUFA plasma levels (r=−0.46, P=0.046) and high saturated fatty acids levels (r=0.49, P=0.034). Growth of skinfolds over 6 months of age was associated with placental fatty acid transporter gene expression. Change in BMI z-score in the first 6 months of life correlated with arm muscle area growth, a measure of lean mass (r=0.62, P=0.003), but not with growth in skinfold thickness. Early infancy weight gain was associated with poor plasma LCPUFA status at birth, and fat deposition in infancy was related to changes in placental lipid handling. Thus, neonatal fatty acid profiles may influence the trajectory of infant growth and fat and lean mass deposition.
Although repeatedly associated with white matter microstructural alterations, bipolar disorder (BD) has been relatively unexplored using complex network analysis. This method combines structural and diffusion magnetic resonance imaging (MRI) to model the brain as a network and evaluate its topological properties. A group of highly interconnected high-density structures, termed the ‘rich-club’, represents an important network for integration of brain functioning. This study aimed to assess structural and rich-club connectivity properties in BD through graph theory analyses.
We obtained structural and diffusion MRI scans from 42 euthymic patients with BD type I and 43 age- and gender-matched healthy volunteers. Weighted fractional anisotropy connections mapped between cortical and subcortical structures defined the neuroanatomical networks. Next, we examined between-group differences in features of graph properties and sub-networks.
Patients exhibited significantly reduced clustering coefficient and global efficiency, compared with controls globally and regionally in frontal and occipital regions. Additionally, patients displayed weaker sub-network connectivity in distributed regions. Rich-club analysis revealed subtly reduced density in patients, which did not withstand multiple comparison correction. However, hub identification in most participants indicated differentially affected rich-club membership in the BD group, with two hubs absent when compared with controls, namely the superior frontal gyrus and thalamus.
This graph theory analysis presents a thorough investigation of topological features of connectivity in euthymic BD. Abnormalities of global and local measures and network components provide further neuroanatomically specific evidence for distributed dysconnectivity as a trait feature of BD.
The first series of radiocarbon dating measurements made at the British Museum Research Laboratory are reported in the following list. The report covers a period during which two instances of radioactive contamination occurred to interrupt dating work, and is consequently a short one.
The second series of radiocarbon measurements made at the British Museum Research Laboratory are reported in the following list. The equipment and method used remain the same as described in our first date list (Barker and Mackey, 1959) and, as stated there, the error terms are not based solely on counting statistics but are widened to include contributions of ±80 years for possible isotopic fractionation effects and ±100 years for the de Vries-effect. Ages are calculated on a half-life of 5568 ± 30 years.
Although the Great Basin of North America has produced some of the most robust and ancient fiber artifact assemblages in the world, many were recovered with poor chronological controls. Consequently, this class of artifacts has seldom been effectively incorporated into general discussions of early chronological and cultural patterns. In recent years, the Great Basin Textile Dating Project has accumulated direct AMS dates on textiles (bags, sandals, mats, cordage, and basketry) from dry caves in the Great Basin, particularly in the northern and western areas. We focus here on the terminal Pleistocene/early Holocene, to identify chronological patterns in this class of artifacts and to evaluate Adovasio’s characterization of the region’s earliest basketry as simple and undecorated. New AMS dates now suggest that the region’s earliest people had sophisticated textile traditions that incorporated numerous decorative elaborations. Some distinctive structures, including Fort Rock sandals and weft-faced plaited textiles, have limited early temporal ranges and may serve as diagnostic indicators for terminal Pleistocene/early Holocene times. Other basketry forms and structures that appear by about 9000 cal B.P. persist into the historic period, suggesting a stronger thread of continuity (especially in the north) from this time than is apparent in lithic traditions