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A consensus workshop on low-calorie sweeteners (LCS) was held in November 2018 where seventeen experts (the panel) discussed three themes identified as key to the science and policy of LCS: (1) weight management and glucose control; (2) consumption, safety and perception; (3) nutrition policy. The aims were to identify the reliable facts on LCS, suggest research gaps and propose future actions. The panel agreed that the safety of LCS is demonstrated by a substantial body of evidence reviewed by regulatory experts and current levels of consumption, even for high users, are within agreed safety margins. However, better risk communication is needed. More emphasis is required on the role of LCS in helping individuals reduce their sugar and energy intake, which is a public health priority. Based on reviews of clinical evidence to date, the panel concluded that LCS can be beneficial for weight management when they are used to replace sugar in products consumed in the diet (without energy substitution). The available evidence suggests no grounds for concerns about adverse effects of LCS on sweet preference, appetite or glucose control; indeed, LCS may improve diabetic control and dietary compliance. Regarding effects on the human gut microbiota, data are limited and do not provide adequate evidence that LCS affect gut health at doses relevant to human use. The panel identified research priorities, including collation of the totality of evidence on LCS and body weight control, monitoring and modelling of LCS intakes, impacts on sugar reduction and diet quality and developing effective communication strategies to foster informed choice. There is also a need to reconcile policy discrepancies between organisations and reduce regulatory hurdles that impede low-energy product development and reformulation.
This research communications addresses the hypothesis that a part of iso 17:0 and anteiso 17:0 in milk fat could come from endogenous extraruminal tissue synthesis. In order to confirm this a linear regression model was applied to calculate the proportions of iso 17:0 and anteiso 17:0 in milk fat that could come from elongation of their putative precursors iso 15:0 and anteiso 15:0, respectively. Sixteen dairy goats were allocated to two simultaneous experiments, in a crossover design with four animals per treatment and two experimental periods of 25 d. In both experiments, alfalfa hay was the sole forage and the forage to concentrate ratio (33 : 67) remained constant. Experimental diets differed on the concentrate composition, either rich in starch or neutral detergent fibre, and they were administered alone or in combination with 30 g/d of linseed oil. Iso 15:0, anteiso 15:0, iso 17:0 and anteiso 17:0, the most abundant branched-chain fatty acids in milk fat, were determined by gas chromatography using two different capillary columns. The regression model resolved that 49% of iso 17:0 and 60% of anteiso 17:0 in milk fat was formed extraruminally from iso 15:0 and anteiso 15:0 elongation.
On September 20, 2017, Hurricane Maria made landfall on Puerto Rico as a category 4 storm, resulting in serious widespread impact across the island, including communication and power outages, water systems impairment, and damage to life-saving infrastructure. In collaboration with the Puerto Rico Department of Health, the Public Health Branch (PHB), operating under the Department of Health and Human Services Incident Response Coordination Team, was tasked with completing assessments of health-care facilities in Puerto Rico to determine infrastructure capabilities and post-hurricane capacity. Additionally, in response to significant data entry and presentation needs, the PHB leadership worked with the Puerto Rico Planning Board to develop and test a new app-based infrastructure capacity assessment tool. Assessments of hospitals were initiated September 28, 2017, and completed November 10, 2017 (n = 64 hospitals, 97%). Assessments of health-care centers were initiated on October 7, 2017, with 186 health-care centers (87%) assessed through November 18, 2017. All hospitals had working communications; however, 9% (n = 17) of health-care centers reported no communication capabilities. For the health-care centers, 114 (61%) reported they were operational but had sustainment needs. In conclusion, health-care facility assessments indicated structural damage issues and operational capacity decreases, while health-care centers reported loss of communication capabilities post-Hurricane Maria.
Social cognition has been associated with functional outcome in patients with first episode psychosis (FEP). Social cognition has also been associated with neurocognition and cognitive reserve. Although cognitive reserve, neurocognitive functioning, social cognition, and functional outcome are related, the direction of their associations is not clear. Therefore, the main aim of this study was to analyze the influence of social cognition as a mediator between cognitive reserve and cognitive domains on functioning in FEP both at baseline and at 2 years.
The sample of the study was composed of 282 FEP patients followed up for 2 years. To analyze whether social cognition mediates the influence of cognitive reserve and cognitive domains on functioning, a path analysis was performed. The statistical significance of any mediation effects was evaluated by bootstrap analysis.
At baseline, as neither cognitive reserve nor the cognitive domains studied were related to functioning, the conditions for mediation were not satisfied. Nevertheless, at 2 years of follow-up, social cognition acted as a mediator between cognitive reserve and functioning. Likewise, social cognition was a mediator between verbal memory and functional outcome. The results of the bootstrap analysis confirmed these significant mediations (95% bootstrapped CI (−10.215 to −0.337) and (−4.731 to −0.605) respectively).
Cognitive reserve and neurocognition are related to functioning, and social cognition mediates in this relationship.
I don't remember the very first time I watched The Wiz (1978). Growing up in a black household during the 1980s, the film was as much a part of my upbringing as the countless hours I spent removing my Jheri curl activator from the sofa, practicing the moonwalk, or listening to my mother and sister's annual Thanksgiving argument about how much salt should go into the collard greens. What I do remember is how much I enjoyed watching The Wiz. Each Thanksgiving Day my six sisters and I would gather around the television set and watch our heroine Dorothy (Diana Ross) travel from her aunt's Harlem apartment to the magical land of Oz. We celebrated the fact that Dorothy ultimately vanquishes her seemingly more powerful foe Evillene, the Wicked Witch of the West (Mabel King). As young black girls, we identified with Dorothy's plight. While we were not battling powerful witches, we were constantly resisting our mother's attempts to socialize us into “respectable” young women. As such, we were fascinated by Evillene, the most oppressive force within Dorothy's life. The gargantuan size of Evillene's body, the hideousness of her face, and the force of her supernatural powers both excited and repulsed us. We eagerly anticipated her first appearance in the film, bursting through the doors of her sweatshop belting, “Don't Nobody Bring Me No Bad News.” We reveled in drawing comparisons between Evillene and our mother, hoping that one day we too could defeat her.
Filarial nematodes possess glutathione transferases (GSTs), ubiquitous enzymes with the potential to detoxify xenobiotic and endogenous substrates, and modulate the host immune system, which may aid worm infection establishment, maintenance and survival in the host. Here we have identified and characterized a σ class glycosylated GST (OoGST1), from the cattle-infective filarial nematode Onchocerca ochengi, which is homologous (99% amino acid identity) with an immunodominant GST and potential vaccine candidate from the human parasite, O. volvulus, (OvGST1b). Onchocerca ochengi native GSTs were purified using a two-step affinity chromatography approach, resolved by 2D and 1D SDS-PAGE and subjected to enzymic deglycosylation revealing the existence of at least four glycoforms. A combination of lectin-blotting and mass spectrometry (MS) analyses of the released N-glycans indicated that OoGST1 contained mainly oligomannose Man5GlcNAc2 structure, but also hybrid- and larger oligommanose-type glycans in a lower proportion. Furthermore, purified OoGST1 showed prostaglandin synthase activity as confirmed by Liquid Chromatography (LC)/MS following a coupled-enzyme assay. This is only the second reported and characterized glycosylated GST and our study highlights its potential role in host-parasite interactions and use in the study of human onchocerciasis.
Mexico has suffered multiple social and natural events that tested its response capacity. Hospital units of the third level of care are an axis of response and a central reference. Guaranteeing their integral and organized response promotes risk prevention and mitigation strategy in emergencies and disasters.
To analyze the national and international regulations and the existing documents about emergency and disasters related to a hospital with the identification of the critical actors in the response.
This research consists of a cross-sectional and descriptive study with a mixed methodology (qualitative and quantitative), that generates a protocol for response in a third level care hospital. Quantitative analysis was carried out using central tendency measurements based on a surveys (training, knowledge) performed in the hospital services that provide a critical response with the ED in emergencies or disasters (ED, ICU, Supplies, Nursing, Operating Room, Security, Hospital Admission, Crisis Committee). In the quantitative analysis, the staff were interviewed about their experience in responding to previous events (to the same critical services), recognizing importance and points of improvement with a discourse analysis methodology.
With the information collected and based on the protocols of Safe Hospital program (PAHO/WHO) we generated a protocol organized by the ED that involves massive victims.
Regulations oblige hospital units to have protocols of action in critical situations linked to Safe Hospital program, so it is a great tool for planning. All the surveyed personnel consider that it is important to have a plan that allows for immediate steps to ensure quality and timely patient care, considering it an ethical and social obligation. Analysis suggests that continuous training and the contribution of an operational plan per service provide security and better prognosis to the victims. The protocol includes all critical response services with a clinical practice guide.
Las prácticas alfareras en perspectiva arqueológica pueden ser estudiadas abordando diferentes aristas concernientes al proceso de producción y los restos materiales asociados a cada etapa. En este trabajo se presentan los resultados obtenidos del análisis tecnológico integral de una muestra extensiva de alfarería procedente del tambo Incaico de Costa de Reyes N°5 (Tinogasta, Catamarca, Argentina). La metodología implementada para lograr los objetivos consiste en la reconstrucción de formas típicas, la observación de cortes frescos en lupa binocular y la petrografía en secciones delgadas, aplicadas a un conjunto alfarero recolectado tanto de contextos superficiales como de excavaciones estratigráficas realizadas en dos recintos del sitio de Costa de Reyes N°5. A través de esta aproximación se han logrado visualizar continuidades y rupturas en el proceso de producción de alfarería y en las recetas aplicadas por los alfareros durante momentos de los períodos Agroalfarero tardío (ca. 900–1450 dC) e Inca (ca. 1480–1532 dC). Mientras que la producción de alfarería durante el período Tardío presenta características heterogéneas y una mayor variabilidad, en momentos Incaicos se observa que las recetas aplicadas por los alfareros para elaborar las pastas cerámicas se homogenizan, lo que se interpreta como un control más estricto sobre las fuentes de materia prima y sobre el proceso de hacer alfarería como un todo.
We report here for the first time the presence of Ophelimus mediterraneus sp. n. in Mediterranean Europe. This species appears to be closely related to Ophelimus maskelli, a well-known invasive pest of Eucalyptus. Based on molecular (cytochrome oxidase I, 28S), morphological (multivariate ratio analysis) and bio-ecological investigations, our study gives unambiguous relevant criteria that allow the discrimination between these two species. A full description of O. mediterraneus sp. n. is also provided. The geographic distribution of O. mediterraneus sp. n. as well as its impact on Eucalyptus species needs to be more widely assessed since its presence may have been confused with O. maskelli in their sympatric introduced areas. Further investigations of potential parasitoids in the native area may thus be welcomed to evaluate classical biological control achievability.
The value of the nosological distinction between non-affective and affective psychosis has frequently been challenged. We aimed to investigate the transdiagnostic dimensional structure and associated characteristics of psychopathology at First Episode Psychosis (FEP). Regardless of diagnostic categories, we expected that positive symptoms occurred more frequently in ethnic minority groups and in more densely populated environments, and that negative symptoms were associated with indices of neurodevelopmental impairment.
This study included 2182 FEP individuals recruited across six countries, as part of the EUropean network of national schizophrenia networks studying Gene–Environment Interactions (EU-GEI) study. Symptom ratings were analysed using multidimensional item response modelling in Mplus to estimate five theory-based models of psychosis. We used multiple regression models to examine demographic and context factors associated with symptom dimensions.
A bifactor model, composed of one general factor and five specific dimensions of positive, negative, disorganization, manic and depressive symptoms, best-represented associations among ratings of psychotic symptoms. Positive symptoms were more common in ethnic minority groups. Urbanicity was associated with a higher score on the general factor. Men presented with more negative and less depressive symptoms than women. Early age-at-first-contact with psychiatric services was associated with higher scores on negative, disorganized, and manic symptom dimensions.
Our results suggest that the bifactor model of psychopathology holds across diagnostic categories of non-affective and affective psychosis at FEP, and demographic and context determinants map onto general and specific symptom dimensions. These findings have implications for tailoring symptom-specific treatments and inform research into the mood-psychosis spectrum.
In conservation biology, population monitoring is a critical step, particularly for endangered groups, such as steppe birds in European agro-ecosystems. Long-term population monitoring allows for determination of species population trends and also provides insights into the relative roles that environmental variability and human activities have on priority species. Here, we compare the population trends of two sympatric, closely related farmland bird species, the Little Bustard Tetrax tetrax and Great Bustard Otis tarda, in a protected area of Central Spain, which is their main stronghold in Europe. Over 12 years of monitoring, the abundance of Little and Great Bustards shifted in opposite directions in our study area. Little Bustard abundance decreased significantly (both males [-56%], and harder-to-detect females [-55%]), while Great Bustard abundance increased significantly (1,800%). Future surveys should be more precise and frequent for Little Bustards to facilitate evaluation of their population status and trends. We recommend annual surveys in 2–3 important locations by region throughout the breeding range for Little Bustards, while for Great Bustard the current regional monitoring programmes would be sufficient.
We determined the molecular epidemiology of Bordetella pertussis isolates to evaluate its potential impact on pertussis reemergence in a population of Mexico. Symptomatic and asymptomatic cases were included. Pertussis infection was confirmed by culture and real-time polymerase chain reaction (PCR). Selected B. pertussis isolates were further analysed; i.e. clonality was analysed by pulsed-field gel electrophoresis (PFGE) and ptxP-ptxA, prn, fim2 and fim3 typing was performed by PCR and sequencing. Out of 11 864 analysed samples, 687 (5.8%) were positive for pertussis, with 244 (36%) confirmed by both culture and PCR whereas 115 (17%) were positive only by culture and 328 (48%) were positive only by PCR. One predominant clone (clone A, n = 62/113; 55%) and three major subtypes (A1, A2 and A3) were identified by PFGE. All 113 selected isolates had the allelic combination ptxP3-ptxA1. The predominant clone A and the three major subtypes (A1, A2 and A3) corresponded to the emerging genotypes ptxP3-ptxA1-prn2-fim2-1-fim3-2 and ptxP3-ptxA1-prn2-fim2-1-fim3-1. In conclusion, the presence of an endemic clone and three predominant subtypes belonging to the genotypes ptxP3-ptxA1-prn2-fim2-1-fim3-2 and ptxP3-ptxA1-prn2-fim2-1-fim3-1 were detected. This finding supports the global spread/expansion reported for these outbreaks associated genotypes.
With brown adipose tissue (BAT) becoming a possible therapeutic target to counteract obesity, the prenatal environment could represent a critical window to modify BAT function and browning of white AT. We investigated if levels of uncoupling protein 1 (UCP1) and UCP1-mediated thermogenesis are altered in offspring exposed to prenatal obesity. Female CD-1 mice were fed a high-fat (HF) or standard-fat (SF) diet for 3 months before breeding. After weaning, all pups were placed on SF. UCP1 mRNA and protein levels were quantified using quantitative real-time PCR and Western blot analysis, respectively, in brown (BAT), subcutaneous (SAT) and visceral (VAT) adipose tissues at 6 months of age. Total and UCP1-dependent mitochondrial respiration were determined by high-resolution respirometry. A Student’s t-test and Mann–Whitney test were used (significance: P<0.05). UCP1 mRNA levels were not different between the HF and SF offspring. UCP1 protein levels, total mitochondrial respiration and UCP1-dependent respiration were significantly higher in BAT from HF males (P=0.02, P=0.04, P=0.005, respectively) and females (P=0.01, P=0.04, P=0.02, respectively). In SAT, the UCP1 protein was significantly lower in HF females (P=0.03), and the UCP1-dependent thermogenesis was significantly lower from HF males (P=0.04). In VAT, UCP1 protein levels and UCP1-dependent respiration were significantly lower only in HF females (P=0.03, P=0.04, respectively). There were no differences in total respiration in SAT and VAT. Prenatal exposure to maternal obesity leads to significant increases in UCP1 levels and function in BAT in offspring with little impact on UCP1 levels and function in SAT and VAT.
To compare the epidemiology, clinical characteristics, and mortality of patients with bloodstream infections (BSI) caused by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (ESBL-EC) versus ESBL-producing Klebsiella pneumoniae (ESBL-KP) and to examine the differences in clinical characteristics and outcome between BSIs caused by isolates with CTX-M versus other ESBL genotypes
As part of the INCREMENT project, 33 tertiary hospitals in 12 countries retrospectively collected data on adult patients diagnosed with ESBL-EC BSI or ESBL-KP BSI between 2004 and 2013. Risk factors for ESBL-EC versus ESBL-KP BSI and for 30-day mortality were examined by bivariate analysis followed by multivariable logistic regression.
The study included 909 patients: 687 with ESBL-EC BSI and 222 with ESBL-KP BSI. ESBL genotype by polymerase chain reaction amplification of 286 isolates was available. ESBL-KP BSI was associated with intensive care unit admission, cardiovascular and neurological comorbidities, length of stay to bacteremia >14 days from admission, and a nonurinary source. Overall, 30-day mortality was significantly higher in patients with ESBL-KP BSI than ESBL-EC BSI (33.7% vs 17.4%; odds ratio, 1.64; P=.016). CTX-M was the most prevalent ESBL subtype identified (218 of 286 polymerase chain reaction-tested isolates, 76%). No differences in clinical characteristics or in mortality between CTX-M and non–CTX-M ESBLs were detected.
Clinical characteristics and risk of mortality differ significantly between ESBL-EC and ESBL-KP BSI. Therefore, all ESBL-producing Enterobacteriaceae should not be considered a homogeneous group. No differences in outcomes between genotypes were detected.
Milk fat composition can be modulated by the inclusion of lipid supplements in ruminant diets. An interaction between the lipid supplement and the forage to concentrate ratio or the type of forage in the rations may affect milk fat composition. However, little is known about the effects of the starch-to-non-forage NDF ratio in the concentrate and lipid supplementation of goat diets. The aim of this work was to determine the role of dietary carbohydrates in goats rations supplemented with linseed oil on animal performance and milk fatty acid (FA) profile. A total of 16 dairy goats were allocated to two simultaneous experiments (two treatments each), in a crossover design with four animals per treatment and two experimental periods of 25 days. In both experiments alfalfa hay was the sole forage and the forage to concentrate ratio (33:67) remained constant. The concentrate in experiment 1 consisted of barley, maize and soybean meal (concentrate rich in starch), whereas it included soybean hulls replacing 25% of barley and 25% maize in experiment 2 (concentrate rich in NDF). As a result, the starch-to-non-forage NDF ratio was 3.1 in experiment 1 and it decreased to 0.8 in experiment 2. Both concentrates were administered either alone or in combination with 30 g/day of linseed oil. Animal performance parameters were not affected by experimental treatments. In contrast, major changes were observed in milk FA profile due to lipid supplementation and the type of concentrate. Linseed oil significantly raised vaccenic and rumenic acids as well as α-linolenic acid and its biohydrogenation intermediates while decreased medium-chain saturated FA (12:0 to 16:0) in milk fat. Milk fat contents of odd and branched-chain FA and trans-10 18:1 responded differently to linseed oil supplementation according to the concentrate fed.