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Despite improvements in the medical and surgical management of infants with CHD, growth failure before surgery in many infants continues to be a significant concern. A nutritional pathway was developed, the aim of which was to provide a structured approach to nutritional care for infants with CHD awaiting surgery.
Materials and methods
The modified Delphi process was development of a nutritional pathway; initial stakeholder meeting to finalise draft guidelines and develop questions; round 1 anonymous online survey; round 2 online survey; regional cardiac conference and pathway revision; and final expert meeting and pathway finalisation.
Paediatric Dietitians from all 11 of the paediatric cardiology surgical centres in the United Kingdom contributed to the guideline development. In all, 33% of participants had 9 or more years of experience working with infants with CHD. By the end of rounds 1 and 2, 76 and 96% of participants, respectively, were in agreement with the statements. Three statements where consensus was not achieved by the end of round 2 were discussed and agreed at the final expert group meeting.
Nutrition guidelines were developed for infants with CHD awaiting surgery, using a modified Delphi process, incorporating the best available evidence and expert opinion with regard to nutritional support in this group.
Auditory processing and spoken word recognition difficulties have been observed in Specific Language Impairment (SLI), raising the possibility that auditory perceptual deficits disrupt word recognition and, in turn, phonological processing and oral language. In this study, fifty-seven kindergarten children with SLI and fifty-three language-typical age-matched controls were assessed with a speech-gating task to measure spoken word recognition, psychophysical tasks to measure auditory Frequency Modulation (FM) detection and Frequency Discrimination (FD), and standardized psychometric tests of phonological processing and oral language. As a group, children with SLI took significantly longer than language-typical controls to recognize words with high neighborhood density, perhaps reflecting subpar phonological representations. FM, but not FD, was significantly worse in SLI. However, while both poorer speech-gating performance and poorer auditory thresholds (FM) were evident in SLI, spoken word recognition did not mediate any relation between auditory perception and either phonological processing or oral language.
The effects of fish oil (FO) supplementation on glycaemic control are unclear, and positive effects may occur only when the phospholipid content of tissue membranes exceeds 14 % as n-3 PUFA. Subjects (n 36, thirty-three completed) were paired based on metabolic parameters and allocated into a parallel double-blind randomised trial with one of each pair offered daily either 6 g of FO (3·9 g n-3 PUFA) or 6 g of maize oil (MO) for 9 months. Hyperinsulinaemic–euglycaemic–euaminoacidaemic (HIEGEAA) clamps (with [6,6 2H2 glucose]) were performed at the start and end of the intervention. Endogenous glucose production (EGP) and whole-body protein turnover (WBPT) were each measured after an overnight fast. The primary outcome involved the effect of oil type on insulin sensitivity related to glycaemic control. The secondary outcome involved the effect of oil type on WBPT. Subjects on FO (n 16) had increased erythrocyte n-3 PUFA concentrations >14 %, whereas subjects on MO (n 17) had unaltered n-3 PUFA concentrations at 9 %. Type of oil had no effect on fasting EGP, insulin sensitivity or total glucose disposal during the HIEGEAA clamp. In contrast, under insulin-stimulated conditions, total protein disposal (P=0·007) and endogenous WBPT (P=0·001) were both increased with FO. In an associated pilot study (n 4, three completed), although n-3 PUFA in erythrocyte membranes increased to >14 % with the FO supplement, the enrichment in muscle membranes remained lower (8 %; P<0·001). In conclusion, long-term supplementation with FO, at amounts near the safety limits set by regulatory authorities in Europe and the USA, did not alter glycaemic control but did have an impact on WBPT.
Research on horticultural therapy approaches suggest that its positive impact on clients may extend beyond direct rehabilitation or vocational gains to more generally improved well-being. Persons in rehabilitation programs may relate to gardening as a previously enjoyed past time, or as a new activity for either leisure or employment purposes. While gardening is a popular leisure activity in many countries, few studies have looked at what specific gardening activities community-based populations pursue. As part of a larger mail-out survey looking at gardening interests of mid-aged women, a sub-sample of physically disabled women was compared to healthy age-matched women on gardening activities and interests. Physical and psychological functioning and well-being were also sampled. Both groups completed the SF-36 Health Survey for Australia/New Zealand, the Symptom Checklist-90-Revised, and a gardening questionnaire tapping gardening activities and hours per month on these activities, as well as the reasons for pursuing gardening. Group differences emerged on physical and psychological functioning variables, but for virtually all gardening variables, group differences were minimal. Overall findings suggest that for this sample of mid-aged women, the presence of physical disability or limitation did not adversely affect their access to and enjoyment of gardening activities.
Several questions remain unanswered regarding the magnitude and time course of cognitive improvement in response to antipsychotic treatment. The purpose of this study was to assess changes in cognitive performance in antipsychotic-naive or minimally medicated patients with first-episode schizophrenia during the first 12 months of treatment, in a case–control design. Patients were treated with flupenthixol decanoate depot injection, according to a standard algorithm. The primary outcome measure was change in MATRICS Cognitive Consensus Battery (MCCB) composite score over 12 months.
The sample comprised 92 patients and 100 healthy controls matched for age, sex, ethnicity and educational status. Cognitive function was assessed by means of the MCCB.
A mixed-effects model identified a significant group × time effect (p ≤ 0.0001) for the MCCB composite score, with patients showing a greater degree of change than the controls. For the other MCCB domains there were significant group × time effects at adjusted significance level for attention and vigilance (p ≤ 0.0001), visual learning (p ≤ 0.0001), verbal learning (p = 0.005) and working memory (p ≤ 0.0001), but not for reasoning and problem solving (p = 0.04), speed of processing (p = 0.03) and social cognition (p = 0.06). There were moderate correlations between change in MCCB composite score and change in symptomatology as assessed by Positive and Negative Syndrome Scale factor analysis-derived domains.
Substantial improvements in cognitive function were observed over and above a practice effect, and were significantly correlated with improvements in psychopathology and functionality.
In 2013, Virginia Republicans nominated two Tea Party conservatives for statewide office: Ken Cuccinelli and Earl Walker Jackson, Sr. They differed in two significant respects: (1) Cuccinelli has more political experience, and (2) Cuccinelli is white and Jackson is black. For this article, we used this quasi-experimental opportunity to examine the racial resentment explanation for Tea Party support. We found no evidence of voting patterns consistent with this characterization of Tea Party supporters. There was no significant gap between Tea Party support for Cuccinelli and Jackson, and Tea Party supporters were far more likely to cast ballots for both candidates than they were to choose one or the other. In fact, we found that racial resentment is positively associated with support for Jackson. In this election, neither Tea Party support nor racial resentment negatively affected support for the black Republican candidate for lieutenant governor.
Short-range elephant Loxodonta africana movements were examined in a heterogeneous landscape mosaic of settlements, crop fields and remnant forest in the Caprivi Strip, Namibia. We explored the penetration of the landscape through the use of permanent pathways and determined the impact of pathway use on crop-raiding location. Pathways were linear, devoid of vegetation and maintained by repeated movement. Functional connectivity of pathways was not species-specific, and pathways were used by various species. Elephants travelled in single file at night and we recorded selective pathway use: females selected pathways away from settlements to access water, whereas males used pathways among settlements to launch crop raids. Proximity of raided fields to the nearest pathway was the only significant spatial variable explaining crop-raiding location. Bulls were responsible for all crop-raiding incidents. We conclude that (1) pathways were the most significant spatial variable influencing which fields were raided, (2) crop-raiding from pathways may maximize foraging efficiency by reducing time spent and distance travelled while foraging, (3) pathways may facilitate penetration of the matrix by connecting predictable resources (crops) with preferred shelter areas, crossing points at roads and preferred drinking spots, and (4) access to the Kwandu River is restricted by settlements, predictably resulting in human–elephant conflict. By highlighting the relevance of pathways for movement of elephants we show that an understanding of the use of pathways is important for land-use planning in conservation landscapes, specifically with regard to human–elephant conflict. We also argue for the need to more fully explore pathway occurrence and use at larger spatial scales.
We have studied the onset of plasticity in coherently-strained semiconductor superlattices, using nano-indentation with spherical indenter tips to observe the full stress-strain curve. The yield pressure is reduced by as much as a factor of two by the presence of the coherency strain. By varying the thicknesses and strains of the superlattice layers, we provide a proof that yield commences over a finite volume. It is properties averaged or summed over this volume which determine the yield pressure. We show that the relevant yield criterion for our experimental data is the rate of change of elastic strain energy with plastic relaxation, integrated over a volume of the order of a micron across. This result is expected to be valid for other systems with highly inhomogenous strain fields, and hence to be applicable to modelling of point contact, and to the design and understanding of structural materials which have coherently-strained microstructure.
Synchrotron photoemission measurements of the Si(2p) and N(ls) levels have been made on Si3N4 thin films grown in-situ by high temperature reaction of Si(100) with NH3. The tunability of the excitation photons allowed the mean-free-path of the emitted photoelectrons to be varied, thereby providing the capability to determine not only the types of chemical species present, but their location within the film as well. The structure of these films consists of an outer monolayer (ML) of Si atoms on top of stoichiometric Si3N4. In addition, there are a smaller number (1/2 ML) of Si atoms with intermediate oxidation states at the Si3N4/Si interface.
High resolution X-ray diffraction space mapping has been used to follow the change in the distribution of residual strain and localised relaxation in low mismatched epitaxial layers. Using this new technique, we have obtained a series of diffraction space maps of partially relaxed epitaxial layers of In.1Ga.9As on GaAs. The layers have different thicknesses and hence different degrees of strain relaxation. The diffuse scatter close to the Bragg peaks provides information about the imperfect and distorted regions in the structure and this has allowed us to examine the extent and distribution of residual strain close to the dislocations. We have followed the evolution of local relaxation, which is confined initially to regions around isolated dislocations, through to the case of overlapping dislocation strain fields, leading to a more homogeneous strain field distribution and microscopic and macroscopic tilting of the layers.
We propose an athermal strengthening mechanism for high-temperature structural materials in which large coherency strains are built in to a layered structure in order to prevent dislocation mulitplication mechanism from functioning. A practical model system is provided by semiconductor strained-layer superlattices of InGaAs grown on InP. We report results from highresolution X-ray diffraction and from direct tensile testing which provide evidence for athermal strengthening. A discussion of methods of micro-mechanical testing is also included.
Grazing-Emission X-Ray Fluorescence Spectrometry (GEXRF) is a new analytical
X-ray fluorescence technique, which like TXRF takes advantage of the
total-reflection phenomenon. The main advantage of GEXRF over TXRF is its
sensitivity towards light elements. This paper presents straight GEXRF and
VPD-DC-GEXRF analysis results for Na, Mg, Al, K and Ca surface contamination
on silicon wafers.
Erythema infectiosum (EI) or fifth disease is a mild, acute exanthematous disease, occurring mainly among children, for which a causative virus has long been sought. In May 1983 an outbreak of exanthematous illness was reported in a primary school in North London. Children attending the school were investigated by questionnaire and 162 (43·9%) reported an illness with the features of EI. In each of 36 cases investigated virologically the illness was associated with parvovirus infection. Moreoever, pre-existing antibody to parvovirus was correlated with protection from EI in 16 of 17 close family contacts of cases. We propose therefore that EI is the common manifestation of infection with the human parvovirus.
Trace amines, including tyramine and β-phenylethylamine (β-PEA), are constituents of many foods including chocolate, cheeses and wines and are generated by so-called ‘friendly’ bacteria such as Lactobacillus, Lactococcus and Enterococcus species, which are found in probiotics. We therefore examined whether these dietary amines could exert pharmacological effects on the gut and its vasculature. In the present study we examined the effects of tyramine and β-PEA on the contractile activity of guinea-pig and rat ileum and upon the isolated mesenteric vasculature and other blood vessels. Traditionally, these amines are regarded as sympathomimetic amines, exerting effects through the release of noradrenaline from sympathetic nerve endings, which should relax the gut. A secondary aim was therefore to confirm this mechanism of action. However, contractile effects were observed in the gut and these were independent of noradrenaline, acetylcholine, histamine and serotonin receptors. They were therefore probably due to the recently described trace amine-associated receptors. These amines relaxed the mesenteric vasculature. In contrast, the aorta and coronary arteries were constricted, a response that was also independent of a sympathomimetic action. From these results, we propose that after ingestion, trace amines could stimulate the gut and improve intestinal blood flow. Restriction of blood flow elsewhere diverts blood to the gut to aid digestion. Thus, trace amines in the diet may promote the digestive process through stimulation of the gut and improved gastrointestinal circulation.
In this paper, we introduce a recently developed methodology for assessing the assumption of causal homogeneity in a time series cross-section Granger framework. Following a description of the procedure and the analytical contexts for which it is appropriate, we implement this new approach to examine the transformation of the post-World War II party system in the South. Specifically, we analyze the causal relationship between black mobilization and GOP growth in the region. We find that black mobilization Granger caused Republican growth throughout the South, whereas Republican growth Granger caused black mobilization only in the deep South. We discuss the substantive significance of our results and conclude with guidelines for the appropriate use of this procedure and suggestions for future extensions of the method.
The present study evaluated the effect of dietary methionine on breast-meat accretion and protein expression in skeletal muscle of broiler chickens in vivo. All broilers received a common pre-test diet up to 21d of age, and were subsequently fed either a methionine-deficient (MD) or -adequate (MA) diet (3·1 V. 4·5g/kg diet) from age 21 to 42d. Dietary cystine levels were 3·7 V. 3·6g/kg diet for the MD and MA diet, respectively. Detrimental effects on carcass yield (P=0·004), abdominal fat percentage (P=0·001), and breast-meat weight (P=0·001), yield (P=0·001), and uniformity (P=0·002) were observed and validated in birds fed MD diets. Via tandem MS, a total of 190 individual proteins were identified from pectoralis major (PM) muscle tissue. From the former composite, peptides from three proteins were observed to be present exclusively in breast muscle from those chickens fed the MD diet (pyruvate kinase, myosin alkali light chain-1, ribosomal-protein-L-29). No proteins were observed to be uniquely expressed in chickens fed MA diets. Research is warranted to further explore the possibility of the proteins pyruate kinase, myosin alkali light chain-1, or ribosomal protein L-29, as potential biological indicators of differences in protein expression of PM of chickens in response to a dietary methionine deficiency.