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CVD and associated metabolic diseases are linked to chronic inflammation, which can be modified by diet. The objective of the present study was to determine whether there is a difference in inflammatory markers, blood metabolic and lipid panels and lymphocyte gene expression in response to a high-fat dairy food challenge with or without milk fat globule membrane (MFGM). Participants consumed a dairy product-based meal containing whipping cream (WC) high in saturated fat with or without the addition of MFGM, following a 12 h fasting blood draw. Inflammatory markers including IL-6 and C-reactive protein, lipid and metabolic panels and lymphocyte gene expression fold changes were measured using multiplex assays, clinical laboratory services and TaqMan real-time RT-PCR, respectively. Fold changes in gene expression were determined using the Pfaffl method. Response variables were converted into incremental AUC, tested for differences, and corrected for multiple comparisons. The postprandial insulin response was significantly lower following the meal containing MFGM (P < 0·01). The gene encoding soluble epoxide hydrolase (EPHX2) was shown to be more up-regulated in the absence of MFGM (P = 0·009). Secondary analyses showed that participants with higher baseline cholesterol:HDL-cholesterol ratio (Chol:HDL) had a greater reduction in gene expression of cluster of differentiation 14 (CD14) and lymphotoxin β receptor (LTBR) with the WC+MFGM meal. The protein and lipid composition of MFGM is thought to be anti-inflammatory. These exploratory analyses suggest that addition of MFGM to a high-saturated fat meal modifies postprandial insulin response and offers a protective role for those individuals with higher baseline Chol:HDL.
Introduction: To describe dosing, duration, and pre- and post-infusion analgesic administration of continuous intravenous sub-dissociative dose ketamine (SDK) infusion for managing a variety of painful conditions in the emergency department (ED). Methods: Retrospective chart review of patients aged 18 and older presenting to the ED with acute and chronic painful conditions who received continuous SDK infusion in the ED for a period over 6 years (2010-2016). Primary data analyses included dosing and duration of infusion, rates of pre- and post-infusion analgesic administration, and final diagnoses. Secondary data included pre- and post-infusion pain scores and rates of side effects. Results: 104 patients were enrolled in the study. Average dosing of ketamine infusion was 11.26 mg/hr, the mean duration of infusion was 135.87 minutes with 38% increase in patients not requiring post-infusion analgesia. The average decrease in pain score was 5.04. There were 12 reported adverse effects with nausea being the most prevalent. Conclusion: Continuous intravenous SDK infusion has a role in controlling pain of various etiologies in the ED with a potential to reduce need for co-analgesics or rescue analgesic administration. There is a need for more robust, prospective, randomized trials that will further evaluate the analgesic efficacy and safety of this modality across wide range of pain syndromes and different age groups in the ED.
Whole apples have not been previously implicated in outbreaks of foodborne bacterial illness. We investigated a nationwide listeriosis outbreak associated with caramel apples. We defined an outbreak-associated case as an infection with one or both of two outbreak strains of Listeria monocytogenes highly related by whole-genome multilocus sequence typing (wgMLST) from 1 October 2014 to 1 February 2015. Single-interviewer open-ended interviews identified the source. Outbreak-associated cases were compared with non-outbreak-associated cases and traceback and environmental investigations were performed. We identified 35 outbreak-associated cases in 12 states; 34 (97%) were hospitalized and seven (20%) died. Outbreak-associated ill persons were more likely to have eaten commercially produced, prepackaged caramel apples (odds ratio 326·7, 95% confidence interval 32·2–3314). Environmental samples from the grower's packing facility and distribution-chain whole apples yielded isolates highly related to outbreak isolates by wgMLST. This outbreak highlights the importance of minimizing produce contamination with L. monocytogenes. Investigators should perform single-interviewer open-ended interviews when a food is not readily identified.
Positive psychological constructs have been associated with reduced suicidal ideation, and interventions to cultivate positive feelings have the potential to reduce suicide risk. This study compares the efficacy of a 6-week, telephone-based positive psychology (PP) intervention against a cognition-focused (CF) control intervention among patients recently hospitalized for depression and suicidal ideation or behavior.
A total of 65 adults with a current major depressive episode reporting suicidal ideation or a recent suicide attempt were enrolled from participating in-patient psychiatric units. Prior to discharge, participants were randomized to the PP (n = 32) or CF (n = 33) intervention. In both interventions, participants received a treatment manual, performed weekly PP (e.g. gratitude letter) or CF (e.g. recalling daily events) exercises, and completed weekly one-on-one telephone sessions over 6 weeks. Between-group differences in hopelessness (primary outcome), depression, suicidality and positive psychological constructs at 6 and 12 weeks were tested using mixed-effects models accounting for intensity of post-hospitalization psychiatric treatment.
Compared with PP, the CF intervention was associated with significantly greater improvements in hopelessness at 6 weeks (β = −3.15, 95% confidence interval −6.18 to −0.12, effect size = −0.84, p = 0.04), but not 12 weeks. Similarly, the CF intervention led to greater improvements in depression, suicidal ideation, optimism and gratitude at 6 and 12 weeks.
Contrary to our hypothesis, the CF intervention was superior to PP in improving hopelessness, other suicide risk factors and positive psychological constructs during a key post-discharge period among suicidal patients with depression. Further study of this CF intervention is warranted in populations at high suicide risk.
We present a simple, accurate method for computing singular or nearly singular integrals on a smooth, closed surface, such as layer potentials for harmonic functions evaluated at points on or near the surface. The integral is computed with a regularized kernel and corrections are added for regularization and discretization, which are found from analysis near the singular point. The surface integrals are computed from a new quadrature rule using surface points which project onto grid points in coordinate planes. The method does not require coordinate charts on the surface or special treatment of the singularity other than the corrections. The accuracy is about O(h3), where h is the spacing in the background grid, uniformly with respect to the point of evaluation, on or near the surface. Improved accuracy is obtained for points on the surface. The treecode of Duan and Krasny for Ewald summation is used to perform sums. Numerical examples are presented with a variety of surfaces.
The 2013 multistate outbreaks contributed to the largest annual number of reported US cases of cyclosporiasis since 1997. In this paper we focus on investigations in Texas. We defined an outbreak-associated case as laboratory-confirmed cyclosporiasis in a person with illness onset between 1 June and 31 August 2013, with no history of international travel in the previous 14 days. Epidemiological, environmental, and traceback investigations were conducted. Of the 631 cases reported in the multistate outbreaks, Texas reported the greatest number of cases, 270 (43%). More than 70 clusters were identified in Texas, four of which were further investigated. One restaurant-associated cluster of 25 case-patients was selected for a case-control study. Consumption of cilantro was most strongly associated with illness on meal date-matched analysis (matched odds ratio 19·8, 95% confidence interval 4·0–∞). All case-patients in the other three clusters investigated also ate cilantro. Traceback investigations converged on three suppliers in Puebla, Mexico. Cilantro was the vehicle of infection in the four clusters investigated; the temporal association of these clusters with the large overall increase in cyclosporiasis cases in Texas suggests cilantro was the vehicle of infection for many other cases. However, the paucity of epidemiological and traceback information does not allow for a conclusive determination; moreover, molecular epidemiological tools for cyclosporiasis that could provide more definitive linkage between case clusters are needed.
Nasal polyposis is characterised by opacification of the nasal cavities, paranasal sinuses and ostiomeatal complexes on computed tomography scanning. Sinonasal bony changes have been reported as disease sequelae.
To assess the prevalence of sinonasal bone expansion, erosion and thickening in patients with nasal polyposis, and to correlate disease severity with the prevalence of bony changes.
A retrospective radiological study was conducted comprising pre-operative computed tomography scans of 104 patients with nasal polyposis and scans of 44 age- and gender-matched individuals (control group) without sinonasal disease. Lund–Mackay scores and bony changes were quantified.
Ninety-three per cent of the study group scans showed sinonasal bony change, with no changes in the control group. Radiological severity of nasal polyposis correlated positively with the prevalence of bony changes (rs = 0.31; p < 0.01).
Sinonasal bony changes were common in the study group. This highlights the importance of pre- and intra-operative imaging, which can help to prevent intra-operative complications. As bony changes may mimic invasive disease, the importance of histological assessment of polyps is emphasised.
Hydrodynamic effects of the relationship between the roll and pitch oscillations in low-aspect-ratio fins, with a laminar section and a rounded leading edge, flapping at transitional to moderately high Reynolds numbers, are considered. The fin is hinged at one end and its roll amplitude is large. Also examined is how this relationship is affected by spanwise twist, which alters the pitch oscillation amplitude and its phase relative to the roll motion. Force, efficiency and surface hot-film-anemometry measurements, and flow visualization are carried out in a tow tank. A fin of an abstracted penguin-wing planform and a NACA 0012 cross-section is used, and the chord Reynolds number varies from 3558 to 150 000 based on total speed. The fin is forced near the natural shedding frequency. Strouhal number and pitch amplitude are directly related when thrust is produced, and efficiency is maximized in narrow combinations of Strouhal number and pitch amplitude when oscillation of the leading-edge stagnation point is minimal. Twist makes the angle of attack uniform along the span and enhances thrust by up to 24 %, while maintaining high efficiency. Only 5 % of the power required to roll is spent to pitch, and yet roll and pitch are directly related. During hovering, dye visualization shows that a diffused leading-edge vortex is produced in rigid fins, which enlarges along the span; however, twist makes the vortex more uniform and the fin in turn requires less power to roll. Low-order phase maps of the measurements of force oscillation versus its derivative are modelled as due to van der Pol oscillators; the higher-order maps show trends in the sub-regimes of the transitional Reynolds number. Fin oscillation imparts a chordwise fluid motion, yielding a Stokes wave in the near-wall vorticity layer. When the roll and pitch oscillations are directly related, the wave is optimized: causing vorticity lift-up as the fin is decelerated at the roll extremity; the potential energy at the stagnation point is converted into kinetic energy; a vortex is produced as the lifted vorticity is wrapped around the leading edge; and free-stream reattachment keeps the vortex trapped. When the twist oscillation is phased along the span, this vortex becomes self-preserving at all amplitudes of twist, indicating the most stable (low-bandwidth) tuned nature.
Quadruple vaccine containing 75 D antigen units of killed type 1 poliovirus was given to children at ages 2, 3 and 4 months followed by a booster dose at 15 months.
The serological response to the primary course was difficult to assess owing to maternal antibody. Antibody titres to the type 1 component after the booster dose were very satisfactory and about 10 times higher than those observed in a similar group of children given attenuated vaccine. Response to the poliovirus types 2 and 3 in the quadruple vaccine was less satisfactory.
Graded doses of attenuated poliovirus type 1 were fed to the children 2 months after the primary course and 1 month after the booster dose. Children who had received no poliovaccine and children immunized with attenuated vaccine were included for comparison.
Immunization with killed vaccine did not greatly affect the size of the minimal infecting dose of live virus but reduced both the duration of the subsequent infection and the titre of virus in the faeces.
The epidemiological significance of these findings is discussed.
Consumption of poultry meat is associated with human Salmonella infections (Revolledo etal. 2006). One way to control the presence of these bacteria in broiler flocks is to make chickens less susceptible to colonisation. Fermented liquid feed may be a potential tool to reduce the Salmonella carriage in broiler chickens (Heres etal. 2003). Fermented liquid feed is a moistened feed with high numbers of lactobacilli (=109cfu/gr), high concentration of lactic acid (= 150mM) and a low pH (<4.5) (Brooks etal. 2003). In the present experiment, a strain identified as Lb. salivarius that has been isolated from chicken gut and has been selected for its probiotic and fermentation properties after a screening method, was assessed for its efficacy in reducing the shedding of Salmonellatyphimurium in poultry.
It has long been known that a number of periodic completely integrable systems are associated to hyperelliptic curves, for which the Abel map linearizes the flow (at least in part). We show that this is true for a relatively recent such system: the periodic discrete reduction of the shallow water equation derived by Camassa and Holm. The associated spectral problem has the same form and evolves in the same way as the spectral problem for a family of finite-dimensional non-periodic Hamiltonian flows introduced by Calogero and Françoise. We adapt the Weyl function method used earlier by us to solve the peakon problem to give an explicit solution to both the periodic discrete Camassa–Holm system and the (non-periodic) Calogero–Françoise system in terms of theta functions.
An experiment to measure the variation in the phenological and apical development ofwinter wheat (cv. Avalon) in England and Scotland is described. Ten sites which ranged from Aberdeen (57·2° N), the most northerly, to Newton Abbot (50·6° N), the most southerly, were included in the survey, and at each site seed was hand-sown in mid-September, October and November 1983. Developmental stages and sampling procedures were precisely defined to ensure uniformity in scoring by the observers at each site. Temperatures during the growing season were in line with the long-term means, though spring was cooler at all sites and summer warmer at most. The range of monthly-mean temperatures between sites was about the same as the difference between consecutive months. The method of analysis of development rates and durations was in terms of thermal time, modified by sensitivity to photoperiod and a vernalization requirement that slowed early development until a number of days of low temperatures had been experienced. In general, crops at northern sites developed more slowly than those in the south and particularly the south-west of England. There was less variation in the timing of apical stages for later sowings. Developmental rates responded linearly to temperature and photoperiod, with the base temperature increasing for later phases of development. The effect of photoperiod in modifying the rate of development was apparent for all developmental phases from emergence to anthesis, longer days accelerating development, but there was no effect on the duration of the grain-filling period. Vernalization exerted its effect solely within the phase from emergence to double ridge, and had a major influence on the variation between sites only for the first sowing.
A sensitive, specific radioimmunoassay for bovine α-lactalbumin (α-la) suitable for measurement of serum, tissue culture media and milk was developed. α-La was not detected in serum from prepubertal male or female cattle, but was detected as early as 60 d of gestation in nulliparous Holstein heifers, the level being greatly increased during the last one third of gestation. Serum from cross bred beef heifers contained less α-la and it was not detected until late gestation. Concentrations of α-la in serum samples from pregnant multiparous Holstein cows decreased at drying-off and subsequently increased just before parturition. Secretion of α-la by mammary tissue explants from steroid-primed prepubertal Holstein heifers was induced by the addition of bovine prolactin, ovine prolactin or human growth hormone to tissue culture media.
A time dependent x-ray diagnostic technique based on the fast rise time characteristics of unitary crystals is demonstrated, and a correction for decay time is determined for anthracene crystals. The method has a probable time resolution capability better than 10 picoseconds. The shape of the x-ray pulse emitted by laser-generated plasmas is measured by this method and found to be similar to the shape of the laser pulse for laser pulse widths of 1.5-3.5 nanoseconds.
At the first meeting of the newly formed Commission on Spectrophotometry, at Paris in 1935, a thorough discussion, aided by several reports, took place on the principles of this branch of astrophysics. So it will be sufficient now to treat only such special points of theory and practice as have won interest by researches of the last few years.
The present report is the first for which this newly-formed Commission has been responsible. In view of this fact, and in view of the still exploratory nature of many investigations in spectrophotometry, as well as the need for the highest measure of individuality in the attack of the not simple problems involved, it would be premature to propose, simple though it might be to do so, any far reaching plans for co-operative schemes of investigation. These undoubtedly will play a part in the later work of the Commission, but what appears to be needed now is a closer definition of the aims of spectrophotometry, and at least a reference to the many branches of the subject where investigation is needed. The present report attempts to deal with these topics in three successive sections, concerned in turn with the unique property of spectrophotometric measures, the fields of application of spectrophotometry, and recent developments in a still incomplete and difficult technique.
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