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CVD and associated metabolic diseases are linked to chronic inflammation, which can be modified by diet. The objective of the present study was to determine whether there is a difference in inflammatory markers, blood metabolic and lipid panels and lymphocyte gene expression in response to a high-fat dairy food challenge with or without milk fat globule membrane (MFGM). Participants consumed a dairy product-based meal containing whipping cream (WC) high in saturated fat with or without the addition of MFGM, following a 12 h fasting blood draw. Inflammatory markers including IL-6 and C-reactive protein, lipid and metabolic panels and lymphocyte gene expression fold changes were measured using multiplex assays, clinical laboratory services and TaqMan real-time RT-PCR, respectively. Fold changes in gene expression were determined using the Pfaffl method. Response variables were converted into incremental AUC, tested for differences, and corrected for multiple comparisons. The postprandial insulin response was significantly lower following the meal containing MFGM (P < 0·01). The gene encoding soluble epoxide hydrolase (EPHX2) was shown to be more up-regulated in the absence of MFGM (P = 0·009). Secondary analyses showed that participants with higher baseline cholesterol:HDL-cholesterol ratio (Chol:HDL) had a greater reduction in gene expression of cluster of differentiation 14 (CD14) and lymphotoxin β receptor (LTBR) with the WC+MFGM meal. The protein and lipid composition of MFGM is thought to be anti-inflammatory. These exploratory analyses suggest that addition of MFGM to a high-saturated fat meal modifies postprandial insulin response and offers a protective role for those individuals with higher baseline Chol:HDL.
A time dependent x-ray diagnostic technique based on the fast rise time characteristics of unitary crystals is demonstrated, and a correction for decay time is determined for anthracene crystals. The method has a probable time resolution capability better than 10 picoseconds. The shape of the x-ray pulse emitted by laser-generated plasmas is measured by this method and found to be similar to the shape of the laser pulse for laser pulse widths of 1.5-3.5 nanoseconds.
Introduction: To describe dosing, duration, and pre- and post-infusion analgesic administration of continuous intravenous sub-dissociative dose ketamine (SDK) infusion for managing a variety of painful conditions in the emergency department (ED). Methods: Retrospective chart review of patients aged 18 and older presenting to the ED with acute and chronic painful conditions who received continuous SDK infusion in the ED for a period over 6 years (2010-2016). Primary data analyses included dosing and duration of infusion, rates of pre- and post-infusion analgesic administration, and final diagnoses. Secondary data included pre- and post-infusion pain scores and rates of side effects. Results: 104 patients were enrolled in the study. Average dosing of ketamine infusion was 11.26 mg/hr, the mean duration of infusion was 135.87 minutes with 38% increase in patients not requiring post-infusion analgesia. The average decrease in pain score was 5.04. There were 12 reported adverse effects with nausea being the most prevalent. Conclusion: Continuous intravenous SDK infusion has a role in controlling pain of various etiologies in the ED with a potential to reduce need for co-analgesics or rescue analgesic administration. There is a need for more robust, prospective, randomized trials that will further evaluate the analgesic efficacy and safety of this modality across wide range of pain syndromes and different age groups in the ED.
Increasing scientific awareness of health and production promoting intestinal bacteria has enhanced the use of probiotic bacteria as active functional ingredients in animal and human nutrition. Strict selection criteria, suggested by Edens (2003), for potential probiotics in order to achieve well established and positive probiotic effects have been engaged, including the safety for the host and the capacity of the strains to be viable as well as metabolically active within the gastrointestinal tract (GI). In vitro methods have been used for screening potential probiotic strains using a dynamic model that mimics in vivo GI conditions as closely as possible. The objective of this study was to isolate, characterise and further select beneficial lactobacillus strains in an attempt to predict candidates that could be used in vivo as chicken probiotic adjuncts.
Wet feeding beneficially affects feed intake and growth rates of poultry in hot climates (Forbes 2003). Fermenting liquid feeds for pigs has been shown to reduce microbial contamination of the feed (Beal et al., 2002) and this could be an added advantage in hot climates. The most desired property of fermented feed is a high lactic acid concentration produced by lactic acid bacteria (LAB) as the fermenting organisms. This high lactic acid concentration resulting in a low pH is responsible for the antimicrobial activity of fermented feeds. This activity is important for food and environmental safety. Grain sorghum is widely used as a food and animal feed cereal in many parts of Africa, Asia and the semi-arid tropics world-wide. It is recognised that differences in the colour of sorghum varieties are due mainly to their concentration of polyphenol compounds mainly tannins. These compounds have some antimicrobial properties and may affect the activity of lactic acid bacteria used to ferment liquid feeds. Little is known about the lactic acid fermentation of sorghum grain for fermented feeds in monogastric nutrition. The present study was designed to compare the fermentation of red and white sorghum with LAB for inclusion as a component of poultry diets.
Due to the practical advantages of fermenting the carbohydrate-rich cereal component of fermented feeds separately and combining it with the protein-rich components just before feeding (Beal et al., 2005; Moran et al., 2006), it is desirable to have a high lactic acid concentration in the fermented cereal component so as to minimise the dilution effect on the acid concentration and pH of the feed when mixed with the protein-rich component at feeding. With the same cereal substrate and lactic acid bacteria (LAB), a key factor that might influence lactic acid production is the particle sizes produced at milling which could affect the amount of sugars available for microbial enzymatic fermentation. Further more, Anguita et al. (2006) indicated that technological processing of ingredients promotes higher starch hydrolysis in addition to increasing the amount of soluble non-starch polysaccharides and modifications in the physicochemical properties depending on the nature of the feed ingredients. The present study was designed to investigate the effect of particle size on fermentation of sorghum for poultry feed.
The control of enteropathogens at farm level is an important aspect of food safety. Contamination of poultry carcasses and eggs with human enteropathogens such as Salmonella spp and Campylobacter spp and subsequent dissemination through in the food chain continues to be a public health concern. In pigs, surveillance studies have shown that feeding liquid diets, and particularly fermented liquid diets reduces the incidence of Salmonella positive herds. Liquid pig feed fermented with lactic acid bacteria for 24 h at 30°C contains ca 200 mMol L-1 of lactic acid and has a pH of 3.8-4.0. This renders the feed resistant to contamination by potential pathogens and, when challenged with high doses of Salmonella or E. coli these organisms are rapidly eliminated from the feed (Beal et al 2002). Feeding fermented liquid feed (FLF) to pigs lowers the gastric pH to 4 or less, reduces the coliform population and increases the lactic acid bacteria: coliform ratio (LAB: Coli) in the gut (van Winsen et al 2001, Scholten et al 2002). The objective of this study was to determine if similar beneficial effects on the gut microflora could be achieved in poultry fed fermented mash diets.
Liquid feed has to be pumped through pipes to deliver it to pigs. The dry matter content of the diet and the distribution of particle size affects a number of physico-chemical properties of the process. These determine the initial power needed to start a pump from the stationary position and to circulate the feed through the system. Particle size also affects the homogeneity of the diet and the extent to which separation occurs during pumping and after delivery to the trough. In ad lib. feeding systems there is an opportunity for feed particles to hydrate and increase in size. These changes could have a significant effect on viscosity and hence the DM concentration of the diet that could be pumped at a particular power loading. In dry diets, particle size distribution is normally assessed and described on the basis of simple dry sieving. However, this method cannot be used with liquid diets. In other applications, the sizes of particles in a suspension have been assessed using laser particle size analysis (Chmelik et al. 2001). This study was designed to 1) Determine the extent to which particle size distribution was changed by different disk mill settings; 2) Examine the change in particle size distribution resulting from steeping the cereal component in water for 24h; 3) Determine the effect of particle size on viscosity.
Introduction: Collaborative Emergency Centres (CECs) provide access to care in rural communities. After hours, registered nurses (RNs) and paramedics work together in the ED with telephone support by an emergency medical services (EMS) physician. The safety of such a model is unknown. Relapse visits are often used as a proxy measure for safety in emergency medicine. The primary outcome of this study is to measure unscheduled relapses to emergency care. Methods: The electronic patient care record (ePCR) database was queried for all patients who visited two CECs from April 1, 2012 to April 1, 2013. Abstracted data included demographics, time, acuity score, clinical impression, chief complaint, and disposition. Records were searched for each discharged CEC patient to identify unscheduled relapses to emergency care, defined as presenting back to EMS, CEC, or any other ED within the Health Authority within 48 hours of CEC discharge. Results: There were 894 CEC visits, of which 66 were excluded due to missing data. The dispositions from CEC were: 131/828 (15.8%) transferred to regional ED; 264/828 (31.9%) discharged home; 488/828 (58.9%) discharged with follow up visit booked; and 11/82 (1.2%) left the CEC without being seen. There was 37/828 (4.5%) visits which relapsed back to emergency care, all of whom were discharged from CEC or left without being seen: 3/828 (0.4%) relapsed back to EMS (two taken to regional ED and one to CEC); 16/828 (1.9%) relapsed to regional ED (by walking-in); and 18/828 (2.2%) had a relapse to the CEC (walk-in). 516/828 (62.3%) CEC visits were resolved in a single visit. Conclusion: This study was based on only two of the 7 operating CECs due to accessing paper-based charts for multiple health regions. We also acknowledge the limitations of using relapse as a proxy for safety, and that low volumes and acuity will make detection of adverse events challenging. Albeit a proxy measure, the rate of patients who relapse to emergency care was under 5% in this case series of two CECs. Most patients had their concern resolved in a single visit to a CEC. Further research is underway to determine the effectiveness, optimal utilization and safety of this collaborative model of rural emergency care.
Whole apples have not been previously implicated in outbreaks of foodborne bacterial illness. We investigated a nationwide listeriosis outbreak associated with caramel apples. We defined an outbreak-associated case as an infection with one or both of two outbreak strains of Listeria monocytogenes highly related by whole-genome multilocus sequence typing (wgMLST) from 1 October 2014 to 1 February 2015. Single-interviewer open-ended interviews identified the source. Outbreak-associated cases were compared with non-outbreak-associated cases and traceback and environmental investigations were performed. We identified 35 outbreak-associated cases in 12 states; 34 (97%) were hospitalized and seven (20%) died. Outbreak-associated ill persons were more likely to have eaten commercially produced, prepackaged caramel apples (odds ratio 326·7, 95% confidence interval 32·2–3314). Environmental samples from the grower's packing facility and distribution-chain whole apples yielded isolates highly related to outbreak isolates by wgMLST. This outbreak highlights the importance of minimizing produce contamination with L. monocytogenes. Investigators should perform single-interviewer open-ended interviews when a food is not readily identified.
Positive psychological constructs have been associated with reduced suicidal ideation, and interventions to cultivate positive feelings have the potential to reduce suicide risk. This study compares the efficacy of a 6-week, telephone-based positive psychology (PP) intervention against a cognition-focused (CF) control intervention among patients recently hospitalized for depression and suicidal ideation or behavior.
A total of 65 adults with a current major depressive episode reporting suicidal ideation or a recent suicide attempt were enrolled from participating in-patient psychiatric units. Prior to discharge, participants were randomized to the PP (n = 32) or CF (n = 33) intervention. In both interventions, participants received a treatment manual, performed weekly PP (e.g. gratitude letter) or CF (e.g. recalling daily events) exercises, and completed weekly one-on-one telephone sessions over 6 weeks. Between-group differences in hopelessness (primary outcome), depression, suicidality and positive psychological constructs at 6 and 12 weeks were tested using mixed-effects models accounting for intensity of post-hospitalization psychiatric treatment.
Compared with PP, the CF intervention was associated with significantly greater improvements in hopelessness at 6 weeks (β = −3.15, 95% confidence interval −6.18 to −0.12, effect size = −0.84, p = 0.04), but not 12 weeks. Similarly, the CF intervention led to greater improvements in depression, suicidal ideation, optimism and gratitude at 6 and 12 weeks.
Contrary to our hypothesis, the CF intervention was superior to PP in improving hopelessness, other suicide risk factors and positive psychological constructs during a key post-discharge period among suicidal patients with depression. Further study of this CF intervention is warranted in populations at high suicide risk.
We present a simple, accurate method for computing singular or nearly singular integrals on a smooth, closed surface, such as layer potentials for harmonic functions evaluated at points on or near the surface. The integral is computed with a regularized kernel and corrections are added for regularization and discretization, which are found from analysis near the singular point. The surface integrals are computed from a new quadrature rule using surface points which project onto grid points in coordinate planes. The method does not require coordinate charts on the surface or special treatment of the singularity other than the corrections. The accuracy is about O(h3), where h is the spacing in the background grid, uniformly with respect to the point of evaluation, on or near the surface. Improved accuracy is obtained for points on the surface. The treecode of Duan and Krasny for Ewald summation is used to perform sums. Numerical examples are presented with a variety of surfaces.
At the first meeting of the newly formed Commission on Spectrophotometry, at Paris in 1935, a thorough discussion, aided by several reports, took place on the principles of this branch of astrophysics. So it will be sufficient now to treat only such special points of theory and practice as have won interest by researches of the last few years.
Two-thirds of the members of the Commission have replied to the request of the chairman for an expression of their opinion. Most of them are in general well satisfied with the existing system of classification and nomenclature. Lindblad reports on successful work upon the determination of absolute magnitudes of faint stars, in many ways. Adams writes: “I might suggest that attention be called in the report to the fact that the ultra-violet spectra, even of stars like β Orionis, show large numbers of lines. As you probably remember, the spectrum of Sirius resembles, at first sight, the solar spectrum. If all observatories had the facilities for getting spectra in the far ultra-violet, this region would probably furnish the best criteria for spectral type.” Merrill suggests: “The nomenclature which, upon the basis of atomic transition, assigns the adjective ‘nebular’ to lines which may not occur in nebulae, and ‘ auroral ‘ to lines which may not occur in the aurora, is surely not an ideal one.
The present report is the first for which this newly-formed Commission has been responsible. In view of this fact, and in view of the still exploratory nature of many investigations in spectrophotometry, as well as the need for the highest measure of individuality in the attack of the not simple problems involved, it would be premature to propose, simple though it might be to do so, any far reaching plans for co-operative schemes of investigation. These undoubtedly will play a part in the later work of the Commission, but what appears to be needed now is a closer definition of the aims of spectrophotometry, and at least a reference to the many branches of the subject where investigation is needed. The present report attempts to deal with these topics in three successive sections, concerned in turn with the unique property of spectrophotometric measures, the fields of application of spectrophotometry, and recent developments in a still incomplete and difficult technique.
There has been a marked change in the past few years in the incidence of interest in stellar spectra. The great initial task of classification has attained its first objective—though the Henry Draper Extension, and other investigations are still progressing. Perhaps a million stars are still accessible to classification with existing instruments; but more and more time is being spent upon individual spectra, and upon theoretical investigations. In these fields progress has been very rapid, and only some of the more important results may be mentioned here.
The 2013 multistate outbreaks contributed to the largest annual number of reported US cases of cyclosporiasis since 1997. In this paper we focus on investigations in Texas. We defined an outbreak-associated case as laboratory-confirmed cyclosporiasis in a person with illness onset between 1 June and 31 August 2013, with no history of international travel in the previous 14 days. Epidemiological, environmental, and traceback investigations were conducted. Of the 631 cases reported in the multistate outbreaks, Texas reported the greatest number of cases, 270 (43%). More than 70 clusters were identified in Texas, four of which were further investigated. One restaurant-associated cluster of 25 case-patients was selected for a case-control study. Consumption of cilantro was most strongly associated with illness on meal date-matched analysis (matched odds ratio 19·8, 95% confidence interval 4·0–∞). All case-patients in the other three clusters investigated also ate cilantro. Traceback investigations converged on three suppliers in Puebla, Mexico. Cilantro was the vehicle of infection in the four clusters investigated; the temporal association of these clusters with the large overall increase in cyclosporiasis cases in Texas suggests cilantro was the vehicle of infection for many other cases. However, the paucity of epidemiological and traceback information does not allow for a conclusive determination; moreover, molecular epidemiological tools for cyclosporiasis that could provide more definitive linkage between case clusters are needed.
A sphenoethmoidal cell is a posterior ethmoid cell that pneumatises superiorly and/or laterally to the sphenoid sinus. Disease within such a cell may cause visual symptoms because of the close relationship of the optic nerve.
This paper reports four cases of chronic rhinosinusitis involving a sphenoethmoidal cell, two with visual loss. The management of such cases is discussed and the current literature is reviewed.
Pathology within a sphenoethmoidal cell must be considered in cases of optic neuropathy. The presence of these cells may be relevant even in cases of seemingly uncomplicated rhinosinusitis as they are associated with a higher rate of optic nerve protrusion and dehiscence.
A straightforward method is presented for computing three-dimensional Stokes flow, due to forces on a surface, with high accuracy at points near the surface. The flow quantities are written as boundary integrals using the free-space Green’s function. To evaluate the integrals near the boundary, the singular kernels are regularized and a simple quadrature is applied in coordinate charts. High order accuracy is obtained by adding special corrections for the regularization and discretization errors, derived here using local asymptotic analysis. Numerical tests demonstrate the uniform convergence rates of the method.