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Despite improvements in the medical and surgical management of infants with CHD, growth failure before surgery in many infants continues to be a significant concern. A nutritional pathway was developed, the aim of which was to provide a structured approach to nutritional care for infants with CHD awaiting surgery.
Materials and methods
The modified Delphi process was development of a nutritional pathway; initial stakeholder meeting to finalise draft guidelines and develop questions; round 1 anonymous online survey; round 2 online survey; regional cardiac conference and pathway revision; and final expert meeting and pathway finalisation.
Paediatric Dietitians from all 11 of the paediatric cardiology surgical centres in the United Kingdom contributed to the guideline development. In all, 33% of participants had 9 or more years of experience working with infants with CHD. By the end of rounds 1 and 2, 76 and 96% of participants, respectively, were in agreement with the statements. Three statements where consensus was not achieved by the end of round 2 were discussed and agreed at the final expert group meeting.
Nutrition guidelines were developed for infants with CHD awaiting surgery, using a modified Delphi process, incorporating the best available evidence and expert opinion with regard to nutritional support in this group.
Maternal diet-induced obesity can cause detrimental developmental origins of health and disease in offspring. Perinatal exposure to a high-fat diet (HFD) can lead to later behavioral and metabolic disturbances, but it is not clear which behaviors and metabolic parameters are most vulnerable. To address this critical gap, biparental and monogamous oldfield mice (Peromyscus polionotus), which may better replicate most human societies, were used in the current study. About 2 weeks before breeding, adult females were placed on a control or HFD and maintained on the diets throughout gestation and lactation. F1 offspring were placed at weaning (30 days of age) on the control diet and spatial learning and memory, anxiety, exploratory, voluntary physical activity, and metabolic parameters were tested when they reached adulthood (90 days of age). Surprisingly, maternal HFD caused decreased latency in initial and reverse Barnes maze trials in male, but not female, offspring. Both male and female HFD-fed offspring showed increased anxiogenic behaviors, but decreased exploratory and voluntary physical activity. Moreover, HFD offspring demonstrated lower resting energy expenditure (EE) compared with controls. Accordingly, HFD offspring weighed more at adulthood than those from control fed dams, likely the result of reduced physical activity and EE. Current findings indicate a maternal HFD may increase obesity susceptibility in offspring due to prenatal programming resulting in reduced physical activity and EE later in life. Further work is needed to determine the underpinning neural and metabolic mechanisms by which a maternal HFD adversely affects neurobehavioral and metabolic pathways in offspring.
Early patterns of gut colonization may predispose children to adult disease. Exposures in utero and during delivery are associated with the infant gut microbiome. Although ~35% of women carry group B strep (GBS; Streptococcus agalactiae) during pregnancy, it is unknown if GBS presence influences the infant gut microbiome. As part of a population-based, general risk birth cohort, stool specimens were collected from infant’s diapers at research visits conducted at ~1 and 6 months of age. Using the Illumina MiSeq (San Diego, CA) platform, the V4 region of the bacterial 16S rRNA gene was sequenced. Infant gut bacterial community compositional differences by maternal GBS status were evaluated using permutational multivariate analysis of variance. Individual operational taxonomic units (OTUs) were tested using a zero-inflated negative binomial model. Data on maternal GBS and infant gut microbiota from either 1 (n=112) or 6-month-old stool (n=150) specimens was available on 262 maternal-child pairs. Eighty women (30.5%) were GBS+, of who 58 (72.5%) were given intrapartum antibiotics. After adjusting for maternal race, prenatal antifungal use and intrapartum antibiotics, maternal GBS status was statistically significantly associated with gut bacterial composition in the 6 month visit specimen (Canberra R2=0.008, P=0.008; Unweighted UniFrac R2=0.010, P=0.011). Individual OTU tests revealed that infants of GBS+ mothers were significantly enriched for specific members of the Clostridiaceae, Ruminococcoceae, and Enterococcaceae in the 6 month specimens compared with infants of GBS- mothers. Whether these taxonomic differences in infant gut microbiota at 6 months lead to differential predisposition for adult disease requires additional study.
This paper considers the role of costless decisions relating to the extraction of a non-renewable resource in the presence of uncertainty. We begin by deriving a size scale of the extractable resource, above which the solution to the valuation and optimal control strategy can be described by analytic solutions; we produce solutions for a general form of operating cost function. Below this critical resource size level the valuation and optimal control strategy must be solved by numerical means; we present a robust numerical algorithm that can solve such a class of problem. We also allow for the embedding of an irreversible investment decision (abandonment) into the optimisation. Finally, we conduct experimentation for each of these two approaches (analytical and numerical), and show how they are consistent with one another when used appropriately. The extensions of this paper's techniques to renewable resources are explored.
Two unique black pepper accessions with very long spikes, hitherto unreported in the world genepool of black pepper, were collected from the centre of origin of the species and characterized. The two accessions can be a valuable genetic source in the improvement of spike length.
In Ontario, Canada, the number of Salmonella Enteritidis (SE) cases increased over the years 2005–2010. A population-based case-control study was undertaken from January to August 2011 for the purpose of identifying risk factors for acquiring illness due to SE within Ontario. A total of 199 cases and 241 controls were enrolled. After adjustment for confounders, consuming any poultry meat [adjusted odds ratio (aOR) 2·24, 95% confidence interval (CI) 1·31–3·83], processed chicken (aOR 3·32, 95% CI 1·26–8·76) and not washing hands following handling of raw eggs (OR 2·82, 95% CI 1·48–5·37) were significantly associated with SE infection. The population attributable fraction was 46% for any poultry meat consumption and 10% for processed chicken. Poultry meat continues to be identified as a risk factor for SE illness. Control of SE at source, as well as proper food handling practices, are required to reduce the number of SE cases.
We present a novel ZnO:Al fabrication process consisting of room-temperature vacuum sputtering followed by an excimer laser annealing (ELA). The ELA treatment improves the optical transmission of the films, and the film resistivities (<1 mΩ·cm) remain stable or improve with increasing laser fluence up to 0.6 J/cm2, as the carrier density increases but the carrier mobility is degraded. This process is followed by a standard dilute HCl chemical texturing step, and produces substrates with suitable texture, conductivity, and transparency properties for thinfilm photovoltaic applications. Substrates resulting from this process display elevated haze levels (80% at 600 nm and 50% at 800 nm) after the wet-chemical etching step. Such substrates have been used to make single junction hydrogenated nanocrystalline silicon solar cells, and an increase in the short-circuit current of up to 2.2 mA/cm2 is observed compared to a substrate deposited by a standard room-temperature sputtering + wet-etch process. This gain is primarily due to increased photo-response in the red due to improved light-scattering, as at wavelengths greater than 600 nm, a gain in photocurrent of up to 1.7 mA/cm2 is observed.
We are interested in utilizing the thermo-switchable properties of precursor poly(p-phenylene vinylene) (PPV) polymers to develop capacitor dielectrics that will fail at specific temperatures due to the material irreversibly switching from an insulator to a conducting polymer. By utilizing different leaving groups on the polymer main chain, the temperature at which the polymer transforms into a conductor can be varied over a range of temperatures. Electrical characterization of thin-film capacitors prepared from several precursor PPV polymers indicates that these materials have good dielectric properties until they reach elevated temperatures, at which point conjugation of the polymer backbone effectively disables the device. Here, we present the synthesis, dielectric processing, and electrical characterization of a new thermo-switchable polymer dielectric.
Over the last three decades Computational Fluid Dynamics (CFD) has gradually joined the
wind tunnel and flight test as a primary flow analysis tool for aerodynamic designers. CFD
has had its most favorable impact on the aerodynamic design of the high-speed cruise
configuration of a transport. This success has raised expectations among aerodynamicists
that the applicability of CFD can be extended to the full flight envelope. However, the
complex nature of the flows and geometries involved places substantially increased demands
on the solution methodology and resources required. Currently most simulations involve
Reynolds-Averaged Navier-Stokes (RANS) codes although Large Eddy Simulation (LES) and
Detached Eddy Suimulation (DES) codes are occasionally used for component analysis or
theoretical studies. Despite simplified underlying assumptions, current RANS turbulence
models have been spectacularly successful for analyzing attached, transonic flows. Whether
or not these same models are applicable to complex flows with smooth surface separation is
an open question. A prerequisite for answering this question is absolute confidence that
the CFD codes employed reliably solve the continuous equations involved. Too often,
failure to agree with experiment is mistakenly ascribed to the turbulence model rather
than inadequate numerics. Grid convergence in three dimensions is rarely achieved. Even
residual convergence on a given grid is often inadequate. This paper discusses issues
involved in residual and especially grid convergence.
Twin and sibling studies have identified specific cognitive phenotypes that may mediate the association between genes and the clinical symptoms of attention deficit hyperactivity disorder (ADHD). ADHD is also associated with lower IQ scores. We aimed to investigate whether the familial association between measures of cognitive performance and the clinical diagnosis of ADHD is mediated through shared familial influences with IQ.
Multivariate familial models were run on data from 1265 individuals aged 6–18 years, comprising 920 participants from ADHD sibling pairs and 345 control participants. Cognitive assessments included a four-choice reaction time (RT) task, a go/no-go task, a choice–delay task and an IQ assessment. The analyses focused on the cognitive variables of mean RT (MRT), RT variability (RTV), commission errors (CE), omission errors (OE) and choice impulsivity (CI).
Significant familial association (rF) was confirmed between cognitive performance and both ADHD (rF=0.41–0.71) and IQ (rF=−0.25 to −0.49). The association between ADHD and cognitive performance was largely independent (80–87%) of any contribution from etiological factors shared with IQ. The exception was for CI, where 49% of the overlap could be accounted for by the familial variance underlying IQ.
The aetiological factors underlying lower IQ in ADHD seem to be distinct from those between ADHD and RT/error measures. This suggests that lower IQ does not account for the key cognitive impairments observed in ADHD. The results have implications for molecular genetic studies designed to identify genes involved in ADHD.