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Non-alcoholic fatty liver disease (NAFLD) is an increasing cause of chronic liver disease that accompanies obesity and the metabolic syndrome. Excess fructose consumption can initiate or exacerbate NAFLD in part due to a consequence of impaired hepatic fructose metabolism. Preclinical data emphasized that fructose-induced altered gut microbiome, increased gut permeability, and endotoxemia play an important role in NAFLD, but human studies are sparse. The present study aimed to determine if two weeks of excess fructose consumption significantly alters gut microbiota or permeability in humans.
We performed a pilot double-blind, cross-over, metabolic unit study in 10 subjects with obesity (body mass index [BMI] 30–40 mg/kg/m2). Each arm provided 75 grams of either fructose or glucose added to subjects’ individual diets for 14 days, substituted isocalorically for complex carbohydrates, with a 19-day wash-out period between arms. Total fructose intake provided in the fructose arm of the study totaled a mean of 20.1% of calories. Outcome measures included fecal microbiota distribution, fecal metabolites, intestinal permeability, markers of endotoxemia, and plasma metabolites.
Routine blood, uric acid, liver function, and lipid measurements were unaffected by the fructose intervention. The fecal microbiome (including Akkermansia muciniphilia), fecal metabolites, gut permeability, indices of endotoxemia, gut damage or inflammation, and plasma metabolites were essentially unchanged by either intervention.
In contrast to rodent preclinical findings, excess fructose did not cause changes in the gut microbiome, metabolome, and permeability as well as endotoxemia in humans with obesity fed fructose for 14 days in amounts known to enhance NAFLD.
Healthcare personnel (HCP) were recruited to provide serum samples, which were tested for antibodies against Ebola or Lassa virus to evaluate for asymptomatic seroconversion.
From 2014 to 2016, 4 patients with Ebola virus disease (EVD) and 1 patient with Lassa fever (LF) were treated in the Serious Communicable Diseases Unit (SCDU) at Emory University Hospital. Strict infection control and clinical biosafety practices were implemented to prevent nosocomial transmission of EVD or LF to HCP.
All personnel who entered the SCDU who were required to measure their temperatures and complete a symptom questionnaire twice daily were eligible.
No employee developed symptomatic EVD or LF. EVD and LF antibody studies were performed on sera samples from 42 HCP. The 6 participants who had received investigational vaccination with a chimpanzee adenovirus type 3 vectored Ebola glycoprotein vaccine had high antibody titers to Ebola glycoprotein, but none had a response to Ebola nucleoprotein or VP40, or a response to LF antigens.
Patients infected with filoviruses and arenaviruses can be managed successfully without causing occupation-related symptomatic or asymptomatic infections. Meticulous attention to infection control and clinical biosafety practices by highly motivated, trained staff is critical to the safe care of patients with an infection from a special pathogen.
Tropical soda apple is an aggressive prickly perennial shrub growing up to 2 m high. It invades open to semishaded areas, including pastures, forests, riparian zones, roadsides, recreational areas, and horticultural and cropping areas. In Australia during August 2010, the weed was identified on the New South Wales Mid North Coast. It is believed that tropical soda apple has been present in this area for a number of years and both systematic and ad hoc surveys have found the weed in other satellite locations. The discovery of tropical soda apple at several cattle handling facilities indicated that cattle are a significant vector for the weed. The aim of this project was to use the National Livestock Identification System (NLIS) data to trace cattle movements from affected properties throughout New South Wales and into other Australian states. This has proved advantageous, as there are few other nonecological mechanisms to systematically trace significant weed movement. We have been able to conduct a pathway analysis of where this weed is likely to occur across New South Wales through the use of NLIS. Importantly, we can use this information to pinpoint surveillance activities for local managers, thus ensuring better use of resources. We have also been able to create a stochastic model for incursions at these sites using information gleaned from the NLIS data.
A study of an inshore southern North Sea population of lesser weever, Echiichthys vipera, on the Suffolk coast, England, found this small, abundant, benthic fish to reach an age of 15 years and suffer an adult mortality rate of only 0.23 y−1. The maximum length observed of 195 mm Standard length (SL) (225 mm total length, TL) was the greatest yet reported and many individuals >140 mm SL (163 mm TL) were caught between 2009 and 2012. Previous studies have reported a maximum of 160 mm TL and a von Bertalanffy asymptotic TL of 150.3 mm. Age structure analysis showed that recruitment into the local inshore Sizewell population continued until 5 or more years of age. A 6 year age of recruitment corresponds to the age when they have been reported to have disappeared from offshore locations and previously assumed to have died from old age. Regular seasonal changes in local abundance were observed with peak captures during May, presumably caused by seasonal immigration, followed by a summer minimum and a second, more variable, maximum in early autumn before the winter minimum. The winter minimum in captures may be due to either inactivity or offshore migration. Lesser weever has evolved a long-lived, slow growing, life history strategy unusual for small benthic fish in the southern North Sea. By spending long periods hidden in sand, using venom for defence and remaining inactive for an extended period each winter, lesser weever has adopted a strategy which favours high survival and increased longevity.
Persuasion and Healing was one of the most significant
books for psychiatry and clinical psychology during the 20th century. Thirty
years after it was first published, Frank was joined by his daughter, Julia
B. Frank, in an expanded edition in 1991. After training in psychology and
medicine at Harvard and Berlin, then psychiatry at the Johns Hopkins
University, he had come to formulate a truly fundamental question: what is
happening when we make a troubled person better? In trying to answer this,
Frank took the study of psychotherapy to a conceptually much higher level,
doing so in a non-partisan manner in times when psychoanalysis was endemic
and highly influential in America. He helped a whole generation think more
deeply about psychotherapy, to see beyond the immediacy of the
doctor–patient situation. The forces that are at work are also to be seen in
religious healing ceremonies, in the prescription of a placebo and in
rhetoric using hermeneutics. In each, the recipient is urged to accept the
therapist's assumptive world and is expected to be the better for doing
This article is an executive summary of a report from the Centers for Disease Control and Prevention Ventilator-Associated Pneumonia Surveillance Definition Working Group, entitled “Developing a new, national approach to surveillance for ventilator-associated events” and published in Critical Care Medicine. The full report provides a comprehensive description of the Working Group process and outcome.
In September 2011, the Centers for Disease Control and Prevention (CDC) convened a Ventilator-Associated Pneumonia (VAP) Surveillance Definition Working Group to organize a formal process for leaders and experts of key stakeholder organizations to discuss the challenges of VAP surveillance definitions and to propose new approaches to VAP surveillance in adult patients (Table 1).
The Individual Recovery Outcomes Counter (I.ROC) is to date the only recovery outcomes instrument developed in Scotland. This paper describes the steps taken to initially assess its validity and reliability, including factorial analysis, internal consistency and a correlation benchmarking analysis.
The I.ROC tool showed high internal consistency. Exploratory factor analysis indicated a two-factor structure comprising intrapersonal recovery (factor 1) and interpersonal recovery (factor 2), explaining between them over 50% of the variance in I.ROC scores. There were no redundant items and all loaded on at least one of the factors. The I.ROC significantly correlated with widely used existing instruments assessing both personal recovery and clinical outcomes.
I.ROC is a valid and reliable measure of recovery in mental health, preferred by service users when compared with well-established instruments. It could be used in clinical settings to map individual recovery, providing feedback for service users and helping to assess service outcomes.
Australia has a generally progressive approach to mental health law, reflective of international trends in human rights. Responsibility for most legislation is vested in the six States and two Territories, a total of eight jurisdictions, such that at any given time several new mental health acts are in preparation. In addition there is a model mental health act that promotes common standards. Transfer of orders between jurisdictions relies on Memoranda of Understanding between them, and is patchy. State and Territory legislation is generally cognisant of international treaty obligations, which are themselves the preserve of the Federal Parliament and legislature. UK legislation has had a key influence in Australia, the 1959 Mental Health Act in particular, with its strong emphasis on voluntary hospitalisation, prefacing deinstitutionalisation.
The Galapagos Archipelago is renowned for its high endemism but little effort has been made to quantify the human disturbance that compromises the islands' ecological integrity. We provide a quantitative assessment of anthropogenic degradation, which we define as areas either transformed by direct human activity or heavily invaded by four of the most prevalent alien plant species (Psidium guajava, Rubus niveus, Cinchona pubescens and Syzygium jambos). We assessed how the amount of degraded area varied among the six major vegetation zones (bare ground, littoral, arid, transition, humid and very humid) across five inhabited or formerly inhabited islands. Overall, we found that 37,833 ha (5.5%) of the Archipelago have been completely degraded. The islands that have suffered the greatest human impact (13,000–14,000 ha each) are Santa Cruz (the most populous) and Isabela (the largest). When vegetation type is considered the humid and very humid vegetation zones have been most affected by humans (29 and 45%, respectively). On San Cristobal and Santa Cruz 100 and 76%, respectively, of the very humid zone and 94 and 88%, respectively, of the humid zone have been transformed. These results are underestimations as mapping of the anthropogenic change in some vegetation zones (e.g. on Floreana) is poor, and the analysis did not take into account the effects of introduced animals. Nevertheless, this research points to an urgent need to prioritize restoration efforts in humid and very humid vegetation zones and to improve spatial mapping across the Archipelago to obtain a better understanding of the impacts of humans.
This article addresses the ongoing impact of Canadian Content Regulations as applied to commercial radio. While commercial broadcasters have repeatedly called for a relaxation of the regulations in response to the changing music industry, particularly the increased impact of the Internet, it is possible to demonstrate that the regulations have had a positive impact on Canadian listening habits. An examination of the ‘national’ charts provided by Last.fm, a website that tracks users’ listening habits, shows that Canadian users listen to Canadian tracks in excess of the amounts currently regulated for radio. Commercial broadcasters’ claims that the regulations prevent them from competing fairly with new technology thus run counter to such evidence. As official charts, and hence commercial playlists are still reliant on older modes of tracking music, via in-store purchases, an incomplete picture of the current state of the industry exists, and it is this picture that seems to shape the claims made by the commercial industry. Additionally, this paper explores the rise of a successful Canadian ‘scene’, spearheaded by bands such as Arcade Fire and Broken Social Scene, that demonstrates the impact of policy in creating a national music culture that is confident enough to no longer have to be explicitly Canadian, either sonically or lyrically. Cancon regulations would appear to have aided in situating Canadian acts comfortably within a wider music culture within Canada.
At least 21 countries have now carried out national surveys of mental health under the aegis of the World Health Organization's World Mental Health Surveys. This has meant interviewing some 157 000 people in their homes. The countries are as varied as Australia, China, Iran, six continental European nations, Nigeria, the UK and the USA (Andrews et al, 2001; Demyttenaere et al, 2004; Mohammadi et al, 2005). It is therefore timely to consider what this very large body of information has yielded and to what use it can be put, especially in relation to the costs and human resources expended in a field where unmet need is so conspicuous.
There has been no comprehensive investigation of psychological health in Australia's Korean War veteran population, and few researchers are investigating the health of coalition Korean War veterans into old age.
To investigate the association between war service, anxiety, post-traumatic stress disorder (PTSD) and depression in Australia's 7525 surviving male Korean War veterans and a community comparison group.
A survey was conducted using a self-report postal questionnaire which included the PTSD Checklist, the Hospital Anxiety and Depression scale and the Combat Exposure Scale.
Post-traumatic stress disorder (OR 6.63, P <0.001), anxiety (OR 5.74, P <0.001) and depression (OR 5.45, P <0.001) were more prevalent in veterans than in the comparison group. These disorders were strongly associated with heavy combat and low rank.
Effective intervention is necessary to reduce the considerable psychological morbidity experienced by Korean War veterans. Attention to risk factors and early intervention will be necessary to prevent similar long-term psychological morbidity in veterans of more recent conflicts.
Patients with psychiatric disorders have an increased rate of cardiovascular morbidity and mortality compared with the general population. Metabolic issues such as weight gain, dyslipidemia, diabetes mellitus, diabetic ketoacidosis, and pancreatitis have been reported with the use of antipsychotic agents. Although atypical antipsychotics have not been linked directly to the development of metabolic syndrome, these medications have been shown to increase risk factors that can lead to metabolic and endocrine disturbances. Therefore, clinicians should provide ongoing monitoring for patients who are being treated for psychiatric disorders with these agents. According to the 2004 Consensus Report on Antipsychotics, screening measures should include baseline and follow-up monitoring of personal/family histories, weight (body mass index), waist circumference, blood pressure, fasting plasma glucose, and fasting lipid profile.