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Previous studies have suggested that vegetarianism can result in a reduction of vitamin B12 circulating levels. The aim of the present study was to investigate the effects of a 3-month dietary intervention with a lacto-ovo-vegetarian diet (VD) on the levels of circulating vitamin B12 in a group of omnivores. We analysed fifty-four omnivorous subjects who followed a VD as a first dietary intervention within the CARDIVEG (Cardiovascular Prevention with Vegetarian Diet) study, a dietary intervention study. VD resulted in a significant reduction (P<0·001) of 51·2 % of vitamin B12 intake and in a significant reduction (P=0·005) of 6·2 % of the circulating levels of vitamin B12 (–24·5 pg/ml). Changes in vitamin B12 intake were significantly correlated with changes in circulating levels of vitamin B12 (R 0·61, P<0·001). Subgroup analyses showed that reduction in circulating vitamin B12 levels was more evident in participants who were younger, overweight, non-smokers and had hypercholesterolaemia. A logistic regression analysis showed that a reduction in vitamin B12 intake greater than the first quartile of the delta changes obtained in the study population (–28·5 %) conferred a significantly higher risk of experiencing a decrease in circulating vitamin B12 levels (OR 10·1; 95 % CI 1·3, 76·1). In conclusion, a 3-month VD period determined a significant reduction in circulating levels of vitamin B12, being significantly correlated with the reduction in vitamin B12 intake. Although a well-planned VD can provide adequate nutrition across all life stages, special care must be taken to ensure adequate vitamin B12 intake and to help prevent deficiency.
A series of clinopyroxenes along the CaMgSi2O6–CaCoSi2O6 join was synthesized by quenching from melts at 1500°C and subsequent annealing at 1250°C (at 0.0001 GPa). This protocol proved to be the most effective to obtain homogenous, impurity-free and stoichiometric pyroxenes. Electron microprobe analyses in energy dispersive mode were conducted and single-crystal X-ray diffraction data were collected on Ca (CoxMg1-x)Si2O6 pyroxenes with x = 0.2, 0.4, 0.5, 0.6. Effects of cation substitution at the M1 site are described. The experimental findings of this study allow us to extend the comparative analysis of the structural features of pyroxenes with divalent cations at the M1 and M2 sites.
To increase reliability of the algorithm used in our fully automated electronic surveillance system by adding rules to better identify bloodstream infections secondary to other hospital-acquired infections.
Intensive care unit (ICU) patients with positive blood cultures were reviewed. Central line–associated bloodstream infection (CLABSI) determinations were based on 2 sources: routine surveillance by infection preventionists, and fully automated surveillance. Discrepancies between the 2 sources were evaluated to determine root causes. Secondary infection sites were identified in most discrepant cases. New rules to identify secondary sites were added to the algorithm and applied to this ICU population and a non-ICU population. Sensitivity, specificity, predictive values, and kappa were calculated for the new models.
Of 643 positive ICU blood cultures reviewed, 68 (10.6%) were identified as central line–associated bloodstream infections by fully automated electronic surveillance, whereas 38 (5.9%) were confirmed by routine surveillance. New rules were tested to identify organisms as central line–associated bloodstream infections if they did not meet one, or a combination of, the following: (I) matching organisms (by genus and species) cultured from any other site; (II) any organisms cultured from sterile site; (III) any organisms cultured from skin/wound; (IV) any organisms cultured from respiratory tract. The best-fit model included new rules I and II when applied to positive blood cultures in an ICU population. However, they didn’t improve performance of the algorithm when applied to positive blood cultures in a non-ICU population.
Electronic surveillance system algorithms may need adjustment for specific populations.
Infect. Control Hosp. Epidemiol. 2015;36(12):1396–1400
We have recently developed a set of equations of state based on the nuclear energy density functional theory providing a unified description of the different regions constituting the interior of neutron stars and magnetars. The nuclear functionals, which were constructed from generalized Skyrme effective nucleon-nucleon interactions, yield not only an excellent fit to essentially all experimental atomic mass data but were also constrained to reproduce the neutron-matter equation of state as obtained from realistic many-body calculations.
We study the impact of a hadron-quark phase transition on the maximum neutron-star mass. The hadronic part of the equation of state relies on the most up-to-date Skyrme nuclear energy density functionals, fitted to essentially all experimental nuclear mass data and constrained to reproduce the properties of infinite nuclear matter as obtained from microscopic calculations using realistic forces. We show that the softening of the dense matter equation of state due to the phase transition is not necessarily incompatible with the existence of massive neutron stars like PSR J1614–2230.
Manual surveillance for central line-associated bloodstream infections (CLABSIs) by infection prevention practitioners is time-consuming and often limited to intensive care units (ICUs). An automated surveillance system using existing databases with patient-level variables and microbiology data was investigated.
Patients with a positive blood culture in 4 non-ICU wards at Barnes-Jewish Hospital between July 1, 2005, and December 31, 2006, were evaluated. CLABSI determination for these patients was made via 2 sources; a manual chart review and an automated review from electronically available data. Agreement between these 2 sources was used to develop the best-fit electronic algorithm that used a set of rules to identify a CLABSI. Sensitivity, specificity, predictive values, and Pearson's correlation were calculated for the various rule sets, using manual chart review as the reference standard.
During the study period, 391 positive blood cultures from 331 patients were evaluated. Eighty-five (22%) of these were confirmed to be CLABSI by manual chart review. The best-fit model included presence of a catheter, blood culture positive for known pathogen or blood culture with a common skin contaminant confirmed by a second positive culture and the presence of fever, and no positive cultures with the same organism from another sterile site. The best-performing rule set had an overall sensitivity of 95.2%, specificity of 97.5%, positive predictive value of 90%, and negative predictive value of 99.2% compared with intensive manual surveillance.
Although CLABSIs were slightly overpredicted by electronic surveillance compared with manual chart review, the method offers the possibility of performing acceptably good surveillance in areas where resources do not allow for traditional manual surveillance.
To develop and evaluate computer algorithms with high negative predictive values that augment traditional surveillance for central line–associated bloodstream infection (CLABSI).
Barnes-Jewish Hospital, a 1,250-bed tertiary care academic hospital in Saint Louis, Missouri.
We evaluated all adult patients in intensive care units who had blood samples collected during the period from July 1, 2005, to June 30,2006, that were positive for a recognized pathogen on culture. Each isolate recovered from culture was evaluated using the definitions for nosocomial CLABSI provided by the National Healthcare Safety Network of the Centers for Disease Control and Prevention. Using manual surveillance by infection prevention specialists as the gold standard, we assessed the ability of various combinations of dichotomous rules to determine whether an isolate was associated with a CLABSI. Sensitivity, specificity, and predictive values were calculated.
Infection prevention specialists identified 67 cases of CLABSI associated with 771 isolates recovered from blood samples. The algorithms excluded approximately 40%-62% of the isolates from consideration as possible causes of CLABSI. The simplest algorithm, with 2 dichotomous rules (ie, the collection of blood samples more than 48 hours after admission and the presence of a central venous catheter within 48 hours before collection of blood samples), had the highest negative predictive value (99.4%) and the lowest specificity (44.2%) for CLABSI. Augmentation of this algorithm with rules for common skin contaminants confirmed by another positive blood culture result yielded in a negative predictive value of 99.2% and a specificity of 68.0%.
An automated approach to surveillance for CLABSI that is characterized by a high negative predictive value can accurately identify and exclude positive culture results not representing CLABSI from further manual surveillance.
The recent site testing pointed out the potential of Dome C for Next
Generation Optical Interferometer. KEOPS (Kilo parsec Explorer
Optical Planet Search) is proposed in a context which also
considere the post VLTI perspectives. This
interferometer will be composed of 36 telescopes with a maximal
baseline of 1 km. This instrument will open new horizons: stellar
imaging, circumstellar environment studies, extra solar planet detection, Earth
like planet search. The possibility of observations in double
field mode takes advantage of the large isopistonic angle to give acces to
faint object (see Elhalkouj 2006). It allows active galactic nuclei and cosmological observations.
The achievement of that project implies different steps. The first
one could be MYKERINOS, proposed by LUAN. This prototype
interferometer, composed to 3 telescopes of 40 cm, demonstrate technological feasibility, complete the specific site
characterisation and contribute to validate the scientific program objectives.
IRAN is a method of beam-combination in the
hypertelescope imaging technique recently introduced by
Labeyrie in optical interferometry. We propose to observe the interferometric image in the pupil plane, performing multi-axial pupil plane interferometry. Imaging is performed in a combined pupil-plane where the point-source intensity distribution (PSID) tends towards a
pseudo Airy disc for a sufficiently large number of telescopes. The image is concentrated into the limited support of the output pupil of the individual telescopes, in which the object-image convolution relation is conserved. Specific deconvolution algorithms have been developped for IRAN hypertelescope imagery, based upon Lucy-like iterative techniques. We show that the classical (image plane) and IRAN (pupil plane) hypertelescope imaging techniques are equivalent if one uses optical fibers for beam transportation. An application to the VLT/VIDA concept is presented.
Recent progress in modeling type Ia supernovae by means of 3-dimensional
hydrodynamic simulations as well as several of the still open questions are
addressed. Our models are based on the assumption that thermonuclear burning
inside a Chandrasekhar-mass C+O white dwarf is similar to turbulent chemical
combustion and that, thus, thermonuclear supernovae can be modeled by means
of numerical methods which have been developed and tested for laboratory and
technical flames. It is shown that the new models have considerable
predictive power and allow to study observable properties of type Ia
supernovae, such as their light curves and spectra, without adjustable
non-physical parameters, and they make firm predictions for the
nucleosynthesis yields from the explosions. This raises a quest for better
data, covering the spectroscopical and photometric evolution in all wave
bands from very early epochs all the way into the nebular phase. First such
results obtained by the European Supernova Collaboration (ESC) for a sample
of nearby SNe Ia and their implications for constraining the models and
systematic differences between them are also discussed.
Patients with chronic obstructive pulmonary disease (COPD) often suffer from weight loss. The aim of the present study was to gain insight into the energy balance of depleted ambulatory COPD patients, in relation to their habitual level of physical activity and consumption of oral nutritional supplements. Clinically stable and weight-stable patients (n 20; BMI 19·8± SD 2·0 kg/m2) were studied 1 and 3 months after rehabilitation or recovery in the clinic and were at random assigned to a control or intervention group with regard to nutritional supplementation. Energy intake was measured with a 7 d food record. Energy expenditure was estimated from a simultaneous 7 d assessment of physical activity with a tri-axial accelerometer for movement registration in combination with measured BMR. Body mass was measured at several time points. The body mass remained stable in both groups after 1 or 3 months and mean energy balances were comparable for both groups. The mean body-mass change between month 1 and 3 was negatively related to the mean physical activity level (r −0·49; P=0·03). Weight change over the 3 months was negatively associated with the physical activity level. These results suggest that knowledge about the individual physical activity level is necessary for the estimation of the energy need of the COPD patient.
We present a case of accidental epidural administration of potassium chloride, which was diagnosed by clinical signs. The genesis of symptoms and signs following such administration is discussed and compared with other published reports.
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