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The use of lactic acid bacteria in pig feeds for the control of coliform pathogens in the intestine is now common. These “probiotic” preparations do not persist in the intestine, and must therefore be added daily. Previous work (Reid and Hillman, in press) has indicated that the proportion of Lactobacillus spp. to coliform bacteria can be affected by the type of starch included in the diet, which may provide a more cost-effective means of controlling coliform pathogens. However, the previous study found the greatest enhancement of Lactobacillus spp with waxy maize, one of the most expensive starches. Consequently, this study sets out to determine whether an enhancement of this proportion could be obtained with a more economical starch, or with mixtures of starches.
The frequency of full syndromal and subsyndromal delirium is understudied.
We conducted a point prevalence study in a general hospital.
Possible delirium identified by testing for inattention was evaluated regarding delirium status (full/subsyndromal delirium) using categorical (Confusion Assessment Method (CAM), DSM-IV) and dimensional (Delirium Rating Scale-Revised-98 (DRS-R98) scores) methods.
In total 162 of 311 patients (52%) screened positive for inattention. Delirium was diagnosed in 55 patients (17.7%) using DSM-IV, 52 (16.7%) using CAM and 58 (18.6%) using DRS-R98⩾12 with concordance for 38 (12.2%) individuals. Subsyndromal delirium was identified in 24 patients (7.7%) using a DRS-R98 score of 7–11 and 41 (13.2%) using 2/4 CAM criteria. Subsyndromal delirium with inattention (v. without) had greater disturbance of multiple delirium symptoms.
The point prevalence of delirium and subsyndromal delirium was 25%. There was modest concordance between DRS-R98, DSM-IV and CAM delirium diagnoses. Inattention should be central to subsyndromal delirium definitions.
Improved understanding of the pattern of white matter changes in early and prodromal Alzheimer's disease (AD) states such as mild cognitive impairment (MCI) is necessary to support earlier preclinical detection of AD, and debate remains whether white matter changes in MCI are secondary to gray matter changes. We applied neuropsychologically based MCI criteria to a sample of normally aging older adults; 32 participants met criteria for MCI and 81 participants were classified as normal control (NC) subjects. Whole-head high resolution T1 and diffusion tensor imaging scans were completed. Tract-Based Spatial Statistics was applied and a priori selected regions of interest were extracted. Hippocampal volume and cortical thickness averaged across regions with known vulnerability to AD were derived. Controlling for cortical thickness, the MCI group showed decreased average fractional anisotropy (FA) and decreased FA in parietal white matter and in white matter underlying the entorhinal and posterior cingulate cortices relative to the NC group. Statistically controlling for cortical thickness, medial temporal FA was related to memory and parietal FA was related to executive functioning. These results provide further support for the potential role of white matter integrity as an early biomarker for individuals at risk for AD and highlight that changes in white matter may be independent of gray matter changes. (JINS, 2013, 19, 1–13)
The feasibility and advantages of using rapid thermal annealing to achieve a proper n+ polysilicon work function are demonstrated. Our data shows that RTA can be used to activate arsenic in the polysilicon gate after a regular furnace anneal or to diffuse and activate arsenic without any prior furnace anneal. Interface states and fixed charges due to RTA can be annealed out at 500°C for 30 min in forming gas. New insights into the diffusion, segregation, and activation of As in polysilicon during furnace and/or rapid thermal annealing have been obtained.
Adolescents' susceptibility to peer influence was examined as a
marker of difficulties in the general process of autonomy development that
was likely to be related to deficits across multiple domains of
psychosocial functioning. A laboratory-based assessment of susceptibility
to peer influence in interactions with a close friend was developed and
examined in relation to corollary reports obtained from adolescents, their
mothers, and close peers at ages 13 and 14. As hypothesized, observed
susceptibility to peer influence with a close friend predicted future
responses to negative peer pressure, but it was also related to broader
markers of problems in functioning, including decreases in popularity, and
increasing levels of depressive symptoms, over time. Susceptibility to
peer influence was also linked to higher concurrent levels of substance
use, externalizing behavior, and sexual activity. Results are interpreted
as reflecting the central role of establishing autonomy with peers in
psychosocial development.This study was
supported by grants from the National Institute of Mental Health
(R01-MH44934 and R01-MH58066).
Localized surface plasmon resonance (LSPR) excitation in silver and gold nanoparticles produces strong extinction and scattering spectra that in recent years have been used for important sensing and spectroscopy applications. This article describes the fabrication, characterization, and computational electrodynamics of plasmonic materials that take advantage of this concept.Two applications of these plasmonic materials are presented: (1) the development of an ultrasensitive nanoscale optical biosensor based on LSPR wavelength-shift spectroscopy and (2) the use of plasmon-sampled and wavelength-scanned surface-enhanced Raman excitation spectroscopy (SERES) to provide new insight into the electromagnetic-field enhancement mechanism.
A diathesis-stress interaction model is used to describe multifinality in adolescent internalizing and risky behavioral outcomes. Problematic behavior associated with adolescent insecure preoccupation (a diathesis) was expected to interact with the level of maternal autonomous discourse (a stressor) to predict specific adolescent outcomes. Assessments of adolescent preoccupied attachment organization, observations of maternal displays of autonomy in mother–adolescent interactions, and adolescent reports of internalizing symptoms and risky behaviors were obtained at age 16. As predicted, maternal autonomy in the mother–adolescent relationship helped to explain multifinality in dysfunctional symptoms among preoccupied adolescents. Adolescent preoccupation was more strongly linked to internalizing behavior when mothers demonstrated low levels of autonomy in interactions with their adolescents and more strongly linked to risky behavior when mothers displayed extremely high levels of autonomy. Implications for autonomy processes in increasing our understanding of how adolescent insecure–preoccupation relates to profiles of specific problems during adolescence are discussed as is the importance of exploring the role of attachment in different contexts.
To determine the diagnostic accuracy of an index of underlying disease severity (Horn's index) in identifying patients with a high probability of having nosocomial Clostridium difficile diarrhea as a complication of antimicrobial therapy.
A prospective cohort study of 252 adult patients admitted to the hospital and receiving antibiotics. Risk factors for C. difficile diarrhea were first determined retrospectively in a different cohort of 300 hospitalized patients (primary cobort) and then prospectively in this cohort of 252 hospitalized patients receiving antibiotics (secondary cohort). At the time of hospital admission, disease was rated by clinicians as mild (1), moderate (2), severe (3), or extremely severe (4) using a modified Horn's index. Multivariable logistic regression analysis was used to determine the odds ratio (OR) for C. difficile diarrhea associated with increasing levels of disease severity.
An urban teaching hospital affiliated with a medical school in Boston, Massachusetts.
The incidence of nosocomial C. difficile diarrhea was 8.7% in the primary cohort and 11% in the secondary cohort. In the prospective cohort study (secondary cohort), the OR for C. difficile diarrhea associated with extremely severe disease was 17.6 (95% confidence interval, 5.8 to 53.5). The sensitivity, specificity, and positive and negative predictive values of a Horn's index score of 3 or more (severe to extremely severe disease) as a predictor of nosocomial C. difficile diarrhea were 79%, 73%, 27%, and 96%, respectively.
These findings provide a means of early stratification of hospitalized patients receiving antibiotics according to their risk for nosocomial C. difficile diarrhea. Patients with severe to extremely severe disease at the time of admission may benefit from careful monitoring of antibiotic prescribing and early attention to infection control issues. In the future, these “high-risk” patients may benefit from prophylaxis studies of novel agents being developed to prevent C. difficile diarrhea.
Laboratory-based surveillance of salmonella isolates serotyped at four state health departments
(Illinois, Michigan, Minnesota and Wisconsin) led to the identification of multistate outbreaks
of salmonella infections during 1990 (176 cases of S. javiana) and 1993 (100 cases of S.
montevideo). Community-based case-control studies and product traceback implicated
consumption of tomatoes from a single South Carolina tomato packer (Packer A) MOR 16·0;
95% CI 2·1, 120·6; P<0·0001 in 1990 and
again in 1993 (MOR 5·7; 95% CI 1·5, 21·9;
P=0·01) as the likely vehicle. Contamination likely occurred at the packing shed, where field
grown tomatoes were dumped into a common water bath. These outbreaks represent part of a
growing trend of large geographically dispersed outbreaks caused by sporadic or low-level
contamination of widely distributed food items. Controlling contamination of agricultural
commodities that are also ready-to-eat foods, particularly fruits and vegetables, presents a
major challenge to industry, regulators and public health officials.