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Studies have shown that the reduction in serum TAG concentrations with long-chain n-3 fatty acid supplementation is highly variable among individuals. The objectives of the present study were to compare the proportions of individuals whose TAG concentrations lowered after high-dose DHA and EPA, and to identify the predictors of response to both modalities. In a double-blind, controlled, crossover study, 154 men and women were randomised to three supplemented phases of 10 weeks each: (1) 2·7 g/d of DHA, (2) 2·7 g/d of EPA and (3) 3 g/d of maize oil, separated by 9-week washouts. As secondary analyses, the mean intra-individual variation in TAG was calculated using the standard deviation from the mean of four off-treatment samples. The response remained within the intra-individual variation (±0·25 mmol/l) in 47 and 57 % of participants after DHA and EPA, respectively. Although there was a greater proportion of participants with a reduction >0·25 mmol/l after DHA than after EPA (45 υ. 32 %; P < 0·001), the mean TAG reduction was comparable between groups (–0·59 (sem 0·04) υ. –0·57 (sem 0·05) mmol/l). Participants with a reduction >0·25 mmol/l after both DHA and EPA had higher non-HDL-cholesterol, TAG and insulin concentrations compared with other responders at baseline (all P < 0·05). In conclusion, supplementation with 2·7 g/d DHA or EPA had no meaningful effect on TAG concentrations in a large proportion of individuals with normal mean TAG concentrations at baseline. Although DHA lowered TAG in a greater proportion of individuals compared with EPA, the magnitude of TAG lowering among them was similar.
Currently it is estimated that about 1 billion people globally have non-alcoholic fatty liver disease (NAFLD), a condition in which liver fat exceeds 5 % of liver weight in the absence of significant alcohol intake. Due to the central role of the liver in metabolism, the prevalence of NAFLD is increasing in parallel with the prevalence of obesity, insulin resistance and other risk factors of metabolic diseases. However, the contribution of liver fat to the risk of type 2 diabetes mellitus and CVD, relative to other ectopic fat depots and to other risk markers, is unclear. Various studies have suggested that the accumulation of liver fat can be reduced or prevented via dietary changes. However, the amount of liver fat reduction that would be physiologically relevant, and the timeframes and dose–effect relationships for achieving this through different diet-based approaches, are unclear. Also, it is still uncertain whether the changes in liver fat per se or the associated metabolic changes are relevant. Furthermore, the methods available to measure liver fat, or even individual fatty acids, differ in sensitivity and reliability. The present report summarises key messages of presentations from different experts and related discussions from a workshop intended to capture current views and research gaps relating to the points above.
The watershed events of September 11, 2001; the anthrax attacks; Hurricane Katrina; and H1N1 necessitated that the United States define alternative mechanisms for disaster response. Specifically, there was a need to shift from a capacity building approach to a capabilities based approach that would place more emphasis on the health care community rather than just first responders. Georgia responded to this initiative by creating a Regional Coordinating Hospital (RCH) infrastructure that was responsible for coordinating regional responses within their individual geographic footprint. However, it was quickly realized that hospitals could not accomplish community-wide preparedness as a single entity and that siloed planning must come to an end. To reconcile this issue, Georgia responded to the 2012 US Department of Health and Human Services concept of coalitions. Georgia utilized the existing RCH boundaries to define its coalition regions and began inviting all medical and nonmedical response partners to the planning table (nursing homes, community health centers, volunteer groups, law enforcement, etc). This new collaboration effectively enhanced emergency response practices in Georgia, but also identified additional preparedness-related gaps that will require attention as our coalitions continue to grow and mature.(Disaster Med Public Health Preparedness. 2016;10:174–179)
We sought to compare two ultrasound simulation interventions used during critical care simulation. The primary outcome was trainee and instructor preference for either intervention. Secondary outcomes included the identification of strengths and weaknesses of each intervention as well as overall merits of ultrasound simulation during high-fidelity, critical care simulation. The populations of interest included emergency medicine trainees and physicians.
This was a randomized crossover study with two ultrasound simulation interventions. 25 trainees and eight emergency physician instructors participated in critical-care simulation sessions. Instructors were involved in session debriefing and feedback. Pre- and post-intervention responses were analyzed for statistically significant differences using t test analyses. Qualitative data underwent thematic analysis and triangulation.
Both trainees and instructors deemed ultrasound simulation valuable by allowing trainees to demonstrate knowledge of indications, correct image interpretation, and clinical integration (p<0.05). Trainees described increased motivation to develop and use ultrasound skills. The edus2 was the preferred intervention, as it enabled functional fidelity and the integration of ultrasound into resuscitation choreography. Instructors preferred the edus2, as it facilitated better assessment of trainees’ skills, thus influencing feedback.
These findings support the use of ultrasound simulation during critical care simulations. The increased functional fidelity associated with edus2 suggests that it is the preferred intervention. Further study of the impact on clinical performance is warranted.
Deflection missions to near-Earth asteroids will encounter non-negligible uncertainties in the physical and orbital parameters of the target object. In order to reliably assess future impact threat mitigation operations such uncertainties have to be quantified and incorporated into the mission design. The implementation of deflection demonstration missions offers the great opportunity to test our current understanding of deflection relevant uncertainties and their consequences, e.g., regarding kinetic impacts on asteroid surfaces. In this contribution, we discuss the role of uncertainties in the NEOTωIST asteroid deflection demonstration concept, a low-cost kinetic impactor design elaborated in the framework of the NEOShield project. The aim of NEOTωIST is to change the spin state of a known and well characterized near-Earth object, in this case the asteroid (25143) Itokawa. Fast events such as the production of the impact crater and ejecta are studied via cube-sat chasers and a flyby vehicle. Long term changes, for instance, in the asteroid's spin and orbit, can be assessed using ground based observations. We find that such a mission can indeed provide valuable constraints on mitigation relevant parameters. Furthermore, the here proposed kinetic impact scenarios can be implemented within the next two decades without threatening Earth's safety.
This study examined whether musical training, ethnicity, and experience with a natural tone language influenced sensitivity to tone while listening to an artificial tone language. The language was designed with three tones, modeled after level-tone African languages. Participants listened to a 15-min random concatenation of six 3-syllable words. Sensitivity to tone was assessed using minimal pairs differing only in one syllable (nonword task: e.g., to-kà-su compared to ca-fí-to) or only in tone (tone task: e.g., to-kà-su compared to to-ká-su). Proficiency in an East Asian heritage language was the strongest predictor of success on the tone task. Asians without tone language experience were no better than other ethnic groups. We conclude by considering implications for research on second language learning, especially as approached through artificial language learning.
Mozambique has been a major site for the export of labour to South Africa for close to 250 years. The development of a vast system of migrant labour to the diamond and gold mines has dominated this story. What is less well known is the history of Mozambique as an exporter of labour to the south-western tip of Africa where the importation of slaves and other forced immigrants transitioned, with little interruption, to the importation of migrant workers. This chapter focuses on the exportation of labour from Mozambique over a century, starting around 1770, and draws attention to the hesitant transition in labour relations at the Cape as they shifted from slavery to indenture and, finally, to contracted labour migration. It outlines the extreme violence needed to establish a labour force and notes that, as in other parts of the world, the end of slavery created the need for imported, foreign labour held under strict indenture. The final part of the chapter examines how the coercive nature of this inheritance came to underlay the system of migrant labour.
The chapter starts by examining the growth of the trade in slaves from Mozambique to the Cape at the end of the eighteenth century. It argues that at this early stage the Portuguese colony began to depend for its revenues on the export of human capital. The sale of the colony's major means of production fatally undermined its ability to attract immigrants and investment, as had Brazil or the Cape Colony, and institutionalised a dependence on the export of labour. Chattel slaves dominated the early years of this trade, but with the implementation of abolition at the Cape in 1808, two new waves of forced immigrants moved from Mozambique to the British colony where they acquired limited rights as freed or ‘apprenticed’ slaves. Like the slaves, they initially came from northern Mozambique, the areas north of Cape Delgado and Madagascar. But as Mozambique opened to trade with Brazil, forced immigrants arrived at the Cape in greater numbers from Quelimane, as well as from Inhambane and Delagoa Bay. During the 1850s, the commerce in slaves across the Atlantic declined sharply and the East African slave trade turned northwards.
In no other society in the world have urbanisation and industrialization been as comprehensively based on migrant labour as in South Africa. Rather than focusing on the well-documented narrative of displacement and oppression, A Long Way Home captures the humanity, agency and creative modes of self-expression of the millions of workers who helped to build and shape modern South Africa. The book spans a three-hundred-year history beginning with the exportation of slave labour from Mozambique in the eighteenth century and ending with the strikes and tensions on the platinum belt in recent years. It shows not only the age-old mobility of African migrants across the continent but also, with the growing demand for labour in the mining industry, the importation of Chinese indentured migrant workers. Contributions include 18 essays and over 90 artworks and photographs that traverse homesteads, chiefdoms and mining hostels, taking readers into the materiality of migrant life and its customs and traditions, including the rituals practiced by migrants in an effort to preserve connections to “home” and create a sense of “belonging”. The essays and visual materials provide multiple perspectives on the lived experience of migrant labourers and celebrate their extraordinary journeys. A Long Way Home was conceived during the planning of an art exhibition entitled ‘Ngezinyawo: Migrant Journeys’ at Wits Art Museum. The interdisciplinary nature of the contributions and the extraordinary collection of images selected to complement and expand on the text make this a unique collection.
Forced immigration from the Southwest Indian Ocean marked life at the Cape of Good Hope for over a century. Winds, currents, and shipping linked the two regions, as did a common international currency, and complementary seasons and crops. The Cape's role as a refreshment station for French, Portuguese, American, and Spanish slave ships proved particularly important in the development of a commerce linking East Africa, Madagascar, and the Mascarenes with the Americas. This slave trade resulted in the landing at the Cape of perhaps as many as 40,000 forced immigrants from tropical Africa and Madagascar. Brought to the Cape as slaves, or freed slaves subjected to strict periods of apprenticeship, these individuals were marked by the experience of a brutal transhipment that bears comparison with the trans-Atlantic Middle Passage. The history of the Middle Passage occupies a central place in the study of slavery in the Americas and plays a vital role in the way many people today situate themselves socially and politically. Yet, for various reasons, this emotive subject is absent from historical discussions of life at the Cape. This article brings it into the history of slavery in the region. By focusing on the long history of this forced immigration, the article also serves to underline the importance of the Cape to the political and economic life of the Southwest Indian Ocean.