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A high degree of vigilance and appropriate diagnostic methods are required to detect Clostridioides difficile infection (CDI). We studied the effectiveness of a multimodal training program for improving CDI surveillance and prevention. Between 2011 and 2016, this program was made available to healthcare staff of acute care hospitals in Catalonia. The program included an online course, two face-to-face workshops and dissemination of recommendations on prevention and diagnosis. Adherence to the recommendations was evaluated through surveys administered to the infection control teams at the 38 participating hospitals. The incidence of CDI increased from 2.20 cases/10 000 patient-days in 2011 to 3.41 in 2016 (P < 0.001). The number of hospitals that applied an optimal diagnostic algorithm rose from 32.0% to 71.1% (P = 0.002). Hospitals that applied an optimal diagnostic algorithm reported a higher overall incidence of CDI (3.62 vs. 1.92, P < 0.001), and hospitals that were more active in searching for cases reported higher rates of hospital-acquired CDI (1.76 vs. 0.84, P < 0.001). The results suggest that the application of a multimodal training strategy was associated with a significant rise in the reporting of CDI, as well as with an increase in the application of the optimal diagnostic algorithm.
The research reported in this Research Communication evaluates the effect of milk acidification on the physicochemical and sensory properties of Licor de Oro (or Gold Liqueur; LO), a traditional alcoholic beverage produced in Chiloé island, Chile, which is made by mixing milk acidified with lemon juice and alcohol at a ratio of 1.0:1.0, along with sugar and other spices. The mixture is stored for a couple of weeks and then filtered to obtain a product with a yellowish-transparent appearance, sweetness and acidic taste, milky and alcoholic notes. The lack of information regarding LO processing, mainly in the amount of acid added to the mixture, leads to products of highly variable quality. Thus, the objective of this study was to evaluate the effect of milk acidification on the physicochemical and sensory properties of LO. Raw milk was acidified using citric acid to six different pH values: 6.7 (control), 6.0, 5.3, 4.6, 3.9 and 3.2. These milk treatments were then used to make LO. A decrease of milk pH led to LO with higher levels of sensorial and titratable acidity. LO obtained at pH 6.7 and 6.0 had higher levels of total protein than other treatments, leading to excessive turbidity. In contrast, treatments made at pH ≤5.3 had a typical transparent appearance of LO. These results suggest that a minimum level of milk acidification is required to obtain LO with desired appearance and composition.
We investigated the distribution of comorbidities among adult tuberculosis (TB) patients in Chiapas, the poorest Mexican state, with a high presence of indigenous population, and a corridor for migrants from Latin America. Secondary analysis on 5508 new adult TB patients diagnosed between 2010 and 2014 revealed that the most prevalent comorbidities were diabetes mellitus (DM; 19.1%) and undernutrition (14.4%). The prevalence of DM in these TB patients was significantly higher among middle aged (41–64 years) compared with older adults (⩾65 years) (38.6% vs. 23.2%; P < 0.0001). The prevalence of undernutrition was lower among those with DM, and higher in communities with high indigenous presence. Immigrants only comprised 2% of all TB cases, but were more likely to have unfavourable TB treatment outcomes (treatment failure, death and default) when compared with those born in Chiapas (29.5% vs. 11.1%; P < 0.05). Unfavourable TB outcomes were also more prevalent among the TB patients with undernutrition, HIV or older age, but not DM (P < 0.05). Our study in Chiapas illustrates the challenges of other regions worldwide where social (e.g. indigenous origin, poverty, migration) and host factors (DM, undernutrition, HIV, older age) are associated with TB. Further understanding of these critical factors will guide local policy makers and health providers to improve TB management.
In dairy goats, the kid rearing system can have critical importance in financial returns. Commonly used criteria for the choice of rearing system are not always clear due to the high number of factors involved. The aim of this study was to quantify all those factors to facilitate decision making. So, the effect of two different kid rearing systems, mixed rearing system (MRS) and artificial rearing system (ARS), on milk yield, milk composition and somatic cell count (SCC), milk yield loss at weaning for MRS, kid growth and costs of the different traits on the financial returns in Murciano-Granadina breed goats was studied. Twenty-four goats per group were used. In the MRS, goats reared only one kid, which had free access to goat milk 24 h a day and were weaned at week 6 of lactation, whereas kids in the ARS were separated from their mothers at kidding, colostrum and artificially reared. In both systems, dams were machine-milked once a day throughout lactation and the records took place weekly. Potential milk yield was estimated according to the oxytocin method up to week 12 of lactation, and was similar for both rearing systems, although a 12.3% drop in potential milk yield at weaning was observed for MRS. During the first 6 weeks of lactation, marketable milk was lower for dams in MRS compared to those in ARS (72.1 v. 113.0 l), but similar for the rest of the experiment (101.5 v. 99.4 l, respectively). Marketable milk composition and SCC throughout the 12 weeks of lactation were unaffected by the rearing system. Artificial rearing system entailed an increment in production cost of 22.2€ per kid compared to the rearing by MRS. A similar economic return per goat and kid was obtained from ARS and MRS in this experiment, although, due to one herd’s prolificacy of 1.8, the actual results would be 16.2€ per goat in favour of MRS. The real interest of this experiment may be the possibility of extrapolation to different flocks with diverse levels of milk production, prolificacy and prices and costs for incomes and outputs, to estimate the production system that increases returns. In conclusion, the results showed an increase in the cost of €22.2 per kid bred in the ARS, compared to the MRS, and a final return of 16.2€ per goat in favour of the mixed system.
In December 2010, a major storm erupted in Saturn’s northern hemisphere near 37° planetographic latitude. This rather surprising event, occurring at an unexpected latitude and time, is the sixth “Great White Spot” (GWS) storm observed over the last century and a half. Such GWS events are extraordinary, planetary-scale atmospheric phenomena that dramatically change the typically bland appearance of the planet. Occurring while the Cassini mission was on orbit at Saturn, the Great Storm of 2010–2011 was well suited for intense scrutiny by the suite of sophisticated instruments onboard the Cassini spacecraft as well by modern instrumentation on ground-based telescopes and onboard the Hubble Space Telescope. This GWS erupted on 5 December close to the peak of a westward jet and generated a major dynamical disturbance that affected the whole latitude band from 25° to 48°N. At the upper cloud level, following the rapid growth of the bright outbreak spot, a blunt aerodynamic-shaped head formed due to interaction of the spot with the westward zonal jet, with the winds reaching velocities of 160 m s−1 along the periphery of the arc. Eastward of the head, the disturbance progressed in the following months forming a turbulent wake or tail with growing vortices, one of them a major enduring anticyclone (called AV) with a size of ~11,000 km. Lightning events were prominent and detected as outbursts and flashes at the head and along the disturbance at both optical and radio wavelengths. The activity of the head ceased after about seven months when AV reached it, leaving the cloud structure and ambient winds perturbed. The tops of the optically dense clouds of the head reached the 300-mbar altitude level (~50 km below tropopause), where a mixture of ices was detected, including (1) a component of water ice lofted over 200 km altitude from its 10-bar condensation level, (2) ammonia ice as the predominant component and (3) a component that might be ammonium hydrogen sulfide ice. The energetics of the frequency and power of lightning, as well as the estimated power generated by the latent heat released in the water-based convection to create the observed dynamical three-dimensional flows, both indicate that the power released for much of the 7-month lifetime of the storm (~1017 Watts) was a significant fraction of Saturn’s total radiated power (~2.2 1017 W). A post-storm depletion of ammonia vapour was also measured in the upper troposphere. The effects of the storm propagated into the stratosphere, forming two warm air masses at the ~0.5- to 5-mbar pressure level altitude that later merged into a so-called “beacon” because of its 80 K temperature excess relative to its surroundings. Related to the stratospheric disturbance, hydrocarbon composition excesses were found, in particular for ethylene (C2H4), in the high stratosphere at the ~0.1- to 0.5-mbar altitude level. Numerical models of the storm dynamics explain the major observed features that essentially result from two processes: (1) a huge and sustained, moist, convective storm at the water clouds (altitude level 10–12 bar, or ~250–275 km below the tropopause) and (2) the interaction of the updraft columns with the ambient winds that generates the turbulent wake consisting of vortices and waves. Model simulations of the GWS require a low vertical shear of the zonal winds and low static stability across the weather layer where the disturbance develops. Its upward propagation into the stratosphere involves Rossby waves and their breaking and energy deposition to form the beacon and induce chemical changes.
The decades-long interval between storms is probably related to the insolation cycle and the long radiative time constant of Saturn’s atmosphere, and several theories for temporarily storing energy have been proposed.
Allylamine (AA)-functionalized surfaces for cell adhesion and tissue engineering generated by plasma reactions present several disadvantages, such as amine degradation after 1 week of storage in air and difficulty in achieving a highly specific surface functionalization. In this work, polypropylene (PP) and polyethylene (PE) films were functionalized with AA by γ irradiation to enhance adhesion and compatibility without changing intrinsic bulk properties, thus avoiding the disadvantages of plasma synthesis. Irradiation grafting was realized by a direct and pre-irradiation oxidation method. The effect of different parameters studied were characterized by Fourier transform infrared spectra, thermogravimetric analysis, differential scanning calorimetry, scanning electron microscopy, and contact angle measurements.
This work presents the synthesis and characterization of TiO2 nanotubes (NTT) with chitosan (CS). In a first stage, electrochemical anodization of titanium foils was used to generate NTT in a membrane-type arrangement. From these experiments, suitable experimental conditions were selected. In a second stage, the synthesized NTT were detached from the titanium foils by sonication. In the third stage, the detached NTT were dispersed in an acid solution containing CS in various concentrations. Finally, the nanotubes-chitosan (NTT/CS) samples were characterized by Scanning Electron Microscopy (SEM), X-ray diffraction (XRD), and Fourier Transform Infrared Spectrometry (FTIR). Our results showed that the NTT presented very regular tube morphology with -OH and Ti-O- functional groups on the surface. The interaction of NTT and chitosan was enhanced by increasing the time of contact during the synthesis of the titanium composites.
Two distinct experiments were carried out to assess the trans-generational and within-generational effects of the parasiticides ivermectin and moxidectin to dung beetles (Coleoptera: Scarabaeidae). In the first experiment, the fertility of Euoniticellus intermedius (Reiche) (Scarabaeinae) was assessed for individuals developing in dung containing 10 µg ivermectin/kg fresh dung, a residue concentration previously shown to be sublethal to larval development. Our results showed that the fertility of adults exposed to these residues as larvae was unaffected. In the second experiment, the fertility of Agrilinus constans (Duftschmid) (Aphodiinae) was determined after females were allowed to feed for three weeks on dung containing different concentrations of moxidectin residues (five concentrations ranging from 0.32–32.00 mg/kg dry dung). The fertility of females was not affected, regardless of the concentration to which they were exposed, even when they were exposed to high moxidectin residues that killed all the offspring. The combined findings of these two experiments emphasise that sublethal effects should be included in models that assess the nontarget effects of faecal residues to insects breeding in dung of livestock treated with veterinary medicinal products.
The heavy reliance on imported soybean meal (SBM) as a protein source makes it necessary for the European pig industry to search for alternatives and to develop pigs that perform efficiently when fed such ingredients. Digestion and metabolism are major physiological processes contributing to variation in feed efficiency. Therefore, an experiment was conducted to assess the effects of replacing SBM with increasing levels of rapeseed meal (RSM) in diets for young pigs on apparent total tract digestibility (ATTD) of energy and nutrients, nitrogen (N) balance, energy metabolism and carbohydrate, protein and fat oxidation. Four diets were fed to 32 pigs (22.7±4.1 kg initial BW) for three weeks. The diets consisted of a control cereal grain-SBM basal diet and three test diets where SBM and wheat were partially replaced with 10%, 20%, and 30% of expeller RSM. Increasing level of RSM in the diets linearly reduced ATTD of organic matter, CP, total carbohydrates, dietary fiber and energy. Utilization of digested nitrogen (DN) for N retention and total N excretion were not affected by RSM inclusion, however, RSM inclusion induced a shift in N excretion from urine to feces. Despite a linear increase in liver to metabolic BW ratio, heat production and utilization of metabolizable energy (ME) for retention were not affected by increasing RSM inclusion. In conclusion, replacing SBM with up to 30% of expeller RSM in nutritionally balanced diets for young pigs reduced the ATTD of most nutrients and energy, but did not affect N and energy retention in the body or efficiency of utilization of DN or ME for retention.
Elevated circulating cholesterol levels are a risk factor for CVD which is also associated with sub-optimal vascular function. There is emerging evidence that anthocyanins can cause beneficial cardio-protective effects by favourably modulating lipoprotein profiles. We compared the effects of blood orange juice which is rich in anthocyanins and blonde orange juice without anthocyanins on LDL-cholesterol and other biomarkers of CVD risk, vascular function and glycaemia. In all, forty-one participants (aged 25–84 years) with a waist circumference >94 cm (men) and >80 cm (women) completed a randomised, open label, two-arm cross-over trial. For 28 d participants ingested (i) 500 ml blood orange juice providing 50 mg anthocyanins/d and (ii) 500 ml blonde orange juice without anthocyanins. There was a minimum 3-week washout period between treatments. LDL-cholesterol and other biomarkers associated with CVD risk and glycaemia were assessed at the start and end of each treatment period. No significant differences were observed in total, HDL- and LDL-cholesterol, TAG, glucose, fructosamine, nitric oxide, C-reactive protein, aortic systolic blood pressure and diastolic blood pressure or carotid-femoral and brachial-ankle pulse wave velocity after 28 d ingestion of blood orange juice compared with standard orange juice. The lack of effect on LDL-cholesterol may be due to the modest concentration of anthocyanins in the blood orange juice.