Search

Disgust is an essential part of the behavioral immune system, protecting the individual from infection. According to the Compensatory Prophylaxis Hypothesis (CPH), disgust sensitivity increases in times of immunosuppression, potentially including pregnancy. We aimed to replicate a previous study observing longitudinal changes in disgust sensitivity in pregnant women. Additionally, for the first time, we explored how recent health problems influence these changes. To do this, we obtained disgust sensitivity measures from 94 women in each trimester and in early postpartum. In contrast to the original study, where disgust sensitivity was highest in the first trimester, we found that overall and animal reminder disgust increased across pregnancy and after birth. In line with the CPH, women who were recently sick in the first trimester had elevated disgust sensitivity at that time. Although disgust sensitivity was significantly higher in the second trimester and postpartum period compared to the first trimester in mothers pregnant with a male fetus, the overall results regarding the effect of fetus sex on disgust sensitivity were mixed. It seems that changing levels of disgust sensitivity during pregnancy and postpartum result from a suite of physiological and psychological changes that occur during this sensitive period of a woman's life. [ABSTRACT FROM AUTHOR]

Safety in paediatric regional anaesthesia Large prospective databases have shown the ability to safely perform paediatric regional anaesthesia with minimal risk of neurological damage [[17]]. Keywords: education; nerve block; paediatrics; regional anaesthesia EN education nerve block paediatrics regional anaesthesia 3 8 6 12/09/22 20230101 NES 230101 The "Plan A" blocks principle aims to bring regional anaesthesia to a wider audience by making basic skills and patient access more widespread [[1]]. Regional anaesthesia for paediatric surgery offers intra- and postoperative analgesia, rather than the ability to perform awake surgery, as seen in adult practice. Complications in pediatric regional anesthesia: an analysis of more than 100,000 blocks from the Pediatric Regional Anesthesia Network. [Extracted from the article]

In order to combat the COVID-19 pandemic, policymakers around the globe have increasingly invested in digital health technologies to support the 'test, track and trace' approach of containing the spread of the novel coronavirus. These technologies include mobile 'contact tracing' applications (apps), which can trace individuals likely to have come into contact with those who have reported symptoms or tested positive for the virus and request that they self-isolate. This paper takes a critical public health perspective that advocates for 'genuine participation' in public health interventions and emphasises the need to take citizen's knowledge into account during public health decision-making. In doing so, it presents and discusses the findings of a UK interview study that explored public views on the possibility of using a COVID-19 contact-tracing app public health intervention at the time the United Kingdom (UK) Government announced their decision to develop such a technology. Findings illustrated interviewees' range and degree of understandings, misconceptions, and concerns about the possibility of using an app. In particular, concerns about privacy and surveillance predominated. Interviewees associated these concerns much more broadly than health by identifying with pre-existent British national narratives associated with individual liberty and autonomy. In extending and contributing to ongoing sociological research with public health, we argue that understanding and responding to these matters is vital, and that our findings demonstrate the need for a forward-looking, anticipatory strategy for public engagement as part of the responsible innovation of the COVID-19 contact-tracing app in the UK. [ABSTRACT FROM AUTHOR]

Background Comparative long-term trends in fatal accident rates in the UK's most hazardous occupations have not been reported. Aims To compare trends in fatal accident rates in six of the most hazardous occupations (the three armed forces, merchant shipping, sea fishing and coal mining) and the general British workforce during peacetime years since 1900. Methods Examinations of annual mortality reports, returns, inquiry files and statistics. The main outcome measure was the fatal accident rate per 100 000 population employed. Results These six occupations accounted for ~40% of all fatal accidents in the British workforce. Fatal accident rates were highest in merchant shipping to 1914 (400–600 per 100 000) and in the Royal Air Force and sea fishing by the early 1920s (around 300 per 100 000). Since the 1950s sea fishing has remained the most hazardous occupation (50–200). Widespread reductions in fatal accident rates for each occupation have been greatest in recent years in the three armed forces and merchant shipping. Compared with the general workforce, relative risks of fatalities have increased in recent decades in all these occupations except shipping. Conclusions All six occupations still have high fatal accident rates. The greatly increased fatalities in sea fishing generally and in the Royal Air Force during its early years reflect, for different reasons, cultures of extreme risk-taking in these two sectors. Reductions in fatality rates in the armed forces over the last 20 years are due largely to decreases in land transport accidents. [ABSTRACT FROM AUTHOR]

Although anthropologists frequently report the centrality of odours in the daily lives and cultural beliefs of many small-scale communities, Western scholars have historically considered the sense of smell as minimally involved in human communication. Here, we suggest that the origin and persistence of this latter view might be a consequence of the fact that most research is conducted on participants from Western societies who, collectively, were rather old (adults), deodorized and desensitized (ODD) to various aspects of olfactory perception. The viewis rapidly changing, however, and this themed issue provides a timely overview of the current state-of-the-art on human chemocommunication. Based on evolutionary models of communication, the papers cover both general mechanisms of odour production by 'senders' and odour perception by 'receivers'. Focus on specific functional contexts includes reciprocal impact of odours between infants and mothers, the role of odour in mate choice and how odours communicate emotion and disease. Finally, a position paper outlines pitfalls and opportunities for the future, against the context of the replication crisis in psychology. We believe a more nuanced view of human chemical communication is within our grasp if we can continue to develop inter-disciplinary insights and expand research activities beyond ODD people. [ABSTRACT FROM AUTHOR]

Odours can have a significant influence on the outcome of social interactions. However, we have yet to characterize the chemical signature of any specific social cue in human body odour, and we know little about how changes in social context influence odour chemistry. Here, we argue that adoption of emerging analytical techniques from other disciplines, such as atmospheric chemistry, might become game-changing tools in this endeavour. First, we describe the use of online chemical ionization time-of-flight mass spectrometry to sensitively measure many hundreds of gas-phase volatile organic compounds in real time. By analysing ambient air emanating from undisturbed individuals or groups, the technique enables a continuous recording of an instantaneous odour change in response to external stimuli and changing social context. This has considerable advantages over the traditional approach of periodic sampling for analysis by gas chromatography. We also discuss multivariate statistical approaches, such as positive matrix factorization, that can effectively sift through this complex datastream to identify linked groups of compounds that probably underpin functional chemosignals. In combination, these innovations offer new avenues for addressing outstanding questions concerning olfactory communication in humans and other species, as well as in related fields using odour, such as biometrics and disease diagnostics. [ABSTRACT FROM AUTHOR]

Objective: To present our data evaluating the feasibility of simultaneous cochlear implantation with resection of acoustic neuroma. Methods: This paper describes a case series of eight adult patients with a radiologically suspected acoustic neuroma, treated at a tertiary referral centre in Newcastle, Australia, between 2012 and 2015. Patients underwent cochlear implantation concurrently with removal of an acoustic neuroma. The approach was translabyrinthine, with facial nerve monitoring and electrically evoked auditory brainstem response testing. Standard post-implant rehabilitation was employed, with three and six months' follow-up data collected. The main outcome measures were: hearing, subjective benefit of implant, operative complications and tumour recurrence. Results: Eight patients underwent simultaneous cochlear implantation with resection of acoustic neuroma over a 3-year period, and had 25–63 months' follow up. There were no major complications. All patients except one gained usable hearing and were daily implant users. Conclusion: Simultaneous cochlear implantation with resection of acoustic neuroma has been shown to be a safe treatment option, which will be applicable in a wide range of clinical scenarios as the indications for cochlear implantation continue to expand. [ABSTRACT FROM AUTHOR]

Northwest Africa (NWA) 10986 is a new mingled lunar meteorite found in 2015 in Western Sahara. This impact melt breccia contains abundant impact melt glass and clasts as large as 0.75 mm. Clasts are predominantly plagioclase and pyroxene‐rich and represent both highland and basalt lithologies. Highland lithologies include troctolites, gabbronorites, anorthositic norites, and troctolitic anorthosites. Basalt lithologies include crystalline clasts with large zoned pyroxenes representing very low titanium to low titanium basalts. In situ geochemical analysis of minerals within clasts indicates that they represent ferroan anorthosite, Mg‐suite, and gabbronorite lithologies as defined by the Apollo sample collection. Clasts representing magnesian anorthosite, or "gap" lithologies, are prevalent in this meteorite. Whole rock and in situ impact glass measurements indicate low incompatible trace element concentrations. Basalt clasts also have low incompatible trace element concentrations and lack evolved KREEP mineralogy although pyroxferroite grains are present. The juxtaposition of evolved, basaltic clasts without KREEP signatures and highland lithologies suggests that these basaltic clasts may represent cryptomare. The lithologies found in NWA 10986 offer a unique and possibly a complete cross section view of the Moon sourced outside of the Procellarum KREEP Terrane. [ABSTRACT FROM AUTHOR]

Kejimkujik National Park, in Nova Scotia, Canada, is a sensitive region for metal(loid) contamination, such as mercury, in part due to long-range atmospheric deposition from global and regional industrial centers. The region is remote from industrial centres, but is downwind of major pollution sources in the Eastern United States and Canada, and historically had numerous gold mining sites. Due to a paucity of long-term atmospheric deposition monitoring in this region, little is known about the response of Kejimkujik lakes to multiple changing global, regional and local atmospheric Hg and metal(loid) sources. Here, we used multiple lake sediment cores to reconstruct anthropogenic depositional fluxes of metal(loid)s of concern for the last ~210 years. Results showed that Kejimkujik lake sediments are highly enriched in lead (Pb), antimony (Sb) and tin (Sn), with post-industrial metal(loid) concentrations being >4-fold greater than natural baseline levels (prior to ~1800) and moderately enriched in silver (Ag), bismuth (Bi), cadmium (Cd), copper (Cu), mercury (Hg), rubidium (Rb), tellurium (Te), thallium (Tl), vanadium (V), tungsten (W) and zinc (Zn), with post-industrial metal(loid) concentrations being between 1.5 and 4-fold greater than natural baseline levels (prior to ~1800). Lake sediment core reconstructions of total atmospheric Hg deposition matched well with Hg wet deposition monitoring data from the overlapped period (1997–2010) being 9.1 ± 2.7 μg/m2/yr and 7.0 ± 0.7 μg/m2/yr respectively. Lakes closest to historic gold mining sites show spikes in Ag, Cd, Sb, Tl, Zn and W during mining periods (~1880 and 1950). Most of the enriched metal(loid)s (EF >1.5) (Ag, Bi, Cu, Hg, Pb, Sb, Sn, V and W) do not appear affected by redox and remobilisation issues. For the other enriched metal(loid)s (EF >1.5) (Cd, Tl, and Zn), remobilisation from upper sediments appears to be occurring within these acidic and DOC rich Kejimkujik lakes. Unlabelled Image • Kejimkujik National Park CA is remote from industrial centers. • Sediment cores were collected to assess sources and deposition over time. • Increasing anthropogenic fluxes of Ag, Bi, Cu, Hg and V over the past ~210 years. • This is due to local gold mining, and inputs from regional and global air pollution. • Anthropogenic Hg fluxes agree with regional monitoring and predicted Hg deposition. [ABSTRACT FROM AUTHOR]

Evidence supporting use of the Functional Movement Screen (FMSTM) to identify athletes' risk of injury is equivocal. Furthermore, few studies account for exposure to risk during analysis. This study investigated the association of FMSTM performance with incidence and burden of match-injuries in adult community rugby players. 277 players performed the FMSTM during pre-season and in-season time-loss injuries and match exposure were recorded. The associations between FMSTM score, pain, and movement-pattern asymmetries with match-injury incidence (≥8-days time-loss/1000hours), severe match-injury incidence (>28-days time-loss/1000hours), and match-injury burden (total time-loss days/1000hours for ≥8-days match-injuries) were analysed using Poisson regression. Multivariate analysis indicated players with pain and movement-pattern asymmetry during pre-season had 2.9 times higher severe match-injury incidence (RR, 90%CI = 2.9, 0.9–9.7) and match-injury burden (RR, 90%CI = 2.9, 1.3–6.6). Players with a typically low FMSTM score (mean – 1SD threshold) were estimated to have a 50% greater match-injury burden compared to players with a typically high FMSTM score (mean + 1SD threshold) as match-injury burden was 10% lower per 1-unit increase in FMSTM score. As the strongest association with injury outcome was found for players with pain and asymmetry, when implementing the FMSTM it is advisable to prioritise these players for further assessment and subsequent treatment. [ABSTRACT FROM AUTHOR]

The growth of Pt films on ZnO(0001)Zn and ZnO(0001)O and their adsorption properties for CO have been studied and compared to results obtained for Pt on α-Al2O3(0001). Samples were prepared by vapor deposition of Pt onto flat substrates in ultra high vacuum, and metal coverages were measured using a quartz-crystal, film thickness monitor. On both ZnO surfaces, Auger electron spectroscopy (AES) and transmission electron microscopy (TEM) indicate that Pt grows in as a 2D film at 300 K, in contrast to results for Pt on α-Al2O3(0001) where 3D particles are formed under these conditions. Furthermore, transmission electron diffraction (TED) showed that the Pt grew as an ordered overlayer on the ZnO crystals. Heating the Pt/ZnO surfaces resulted in the formation of Pt particles starting at ∼650 K, but the Pt particles were still oriented with the ZnO. On both ZnO surfaces, temperature programmed desorption (TPD) curves for CO from high Pt coverages (>one monolayer) and from Pt particles formed by heating thinner films were identical to TPD curves for CO from Pt on α-Al2O3(0001). The main desorption features were observed at 400 and 510 K and are interpreted as being due to different site geometries on the Pt by comparison to results from Pt single crystals. However, for Pt at submonolayer coverages prior to particle formation, the TPD curves for CO from Pt on ZnO(0001)Zn were shifted down in temperature by ∼60 K compared to results for Pt on ZnO(0001)O. These results are interpreted as indicating a chemical interaction between Pt and the Zn+2 ions which are in direct contact. [ABSTRACT FROM AUTHOR]

Abstract: Background: Individuals with intellectual disability (ID) are at greater risk of exposure to traumatic life events compared with the non‐ID population. Yet no study to date has examined the role of multiple traumatisation and subsequent psychopathology in people with ID. The aim of this study was to explore the association between multiple traumatisation and subsequent mental health. Methods: A preliminary cross‐sectional study involving 33 participants with DSM‐5 post‐traumatic stress disorder completed self‐report questionnaires on exposure to traumatic life events and post‐traumatic stress disorder symptoms, anxiety, depression and general distress. Results: A proportion of 42.4% of the sample reported multiple traumatisation, including exposure to life events in both childhood and adulthood. Those who reported exposure to life events in childhood and adulthood reported significantly higher risk of harm, depression and general psychological distress compared with those who reported exposure to life events only in adulthood. Conclusions: Preliminary results indicate that more severe psychopathology is associated with multiple traumatisation in childhood and adulthood compared with trauma experienced solely in adulthood. [ABSTRACT FROM AUTHOR]

Abstract: Background and Aims: Under industrial conditions, fermenting juice is normally not mechanically agitated; thermodynamic forces will lead to some rotating motion of the medium. At laboratory scale, research aims to mimic industrial conditions using a standardised synthetic grape juice‐like medium. The level of agitation applied, however, to fermentations differs between the studies. In this study, we investigated the influence of agitation speed on fermentation parameters, including fermentation kinetics, yeast cell production and volatile aroma production. Methods and Results: These parameters were evaluated during fermentations under different agitation conditions. Agitation speed was found to significantly influence all the parameters monitored. In the evaluated conditions, a speed of 80 rpm was optimal for the production of fermentative aromas (lead to the highest production) while guaranteeing the complete and rapid fermentation and limiting the production of off‐flavours. Fermentation of a Chardonnay grape juice in 50 L tanks confirmed the results, and the panellists described the wine produced by the stirred fermentation as sweeter but it is likely that the panellists meant softer because the wines were dry. Conclusions: Agitation is an important parameter to control during fermentation under laboratory conditions. The data also suggest that the type and strength of agitation in commercial fermentations may have a more significant impact than previously thought. Significance of the Study: This study demonstrates that researchers must take into account the importance of agitation during their studies. Similarly, winemakers might consider constant agitation of their tanks. [ABSTRACT FROM AUTHOR]

Abstract: Recent research has highlighted how Lake Baikal, Siberia, has responded to the direct and indirect effects of climate change (e.g., ice‐cover duration), nutrient loading, and pollution, manifesting as changes in phytoplankton/zooplankton populations, community structure, and seasonal succession. Here, we combine and compare analyses of chlorophyll a (an estimate of total algal biomass), carotenoid pigments (biomarkers of algal groups), and lake water silicon isotope geochemistry (δ30SiDSi) to differentiate spatial patterns in dissolved silicon (DSi) uptake at Lake Baikal. A total of 15 sites across the three basins (south, central, and north) of Lake Baikal were sampled in August 2013 along a depth gradient of 0–180 m. Strong, significant correlations were found between vertical profiles of photic zone DSi concentrations and δ30SiDSi compositions (r = −0.81, p < 0.001), although these are strongest in the central basin aphotic zone (r = −0.98, p < 0.001). Data refute the hypothesis of DSi uptake by picocyanobacteria. Algal biomass profiles and high surface δ30SiDSi compositions suggest greater productivity in the south basin and more oligotrophic conditions in the north basin. δ30SiDSi signatures are highest at depth (20 m) in central basin sites, indicating greater (10–40%) DSi utilization at deep chlorophyll maxima. DSi limitation occurs in the pelagic central basin, probably reflecting a high diatom biomass bloom event (Aulacoseira baicalensis). Meanwhile in the more hydrologically restricted, shallow Maloe More region (central basin), both high δ30SiDSi compositions and picocyanobacteria (zeaxanthin) concentrations, respectively point to the legacy of an “Aulacoseira bloom year” and continuous nutrient supply in summer months (e.g., localized eutrophication). [ABSTRACT FROM AUTHOR]

Abstract: Background: Early oral feeding after surgery is best practice among adult, noncritically ill patients. Evidenced‐based guidelines (EBG) recommend commencing liquid and solid feeding within 24 h of surgery to improve patient (e.g. reduced morbidity) and hospital (e.g. reduced length of stay) outcomes. Whether these EBG are adhered to in usual clinical practice remains unknown. The present study aimed to identify the time to commencement of first oral feed (liquid or solid) and first solid feed among postoperative, noncritically ill, adult patients. Methods: MEDLINE, CINAHL, SCOPUS and Web of Science databases were searched from inception to June 2016 for observational studies reporting liquid and/or solid feeding practices among postoperative patients. Studies reporting a mean/median time to first feed or first solid feed within 24 h of surgery or where ≥75% of patients were feeding by postoperative day one were considered in‐line with EBG. Results: Of 5826 articles retrieved, 29 studies were included. Only 40% and 22% of studies reported time to first feed and time to first solid feed in‐line with EBG, respectively. Clear and free liquids were the first diet types commenced in 86% of studies. When solids were commenced, 44% of studies reported using various therapeutic diet types (e.g. light) prior to the commencement of a regular diet. Patients who underwent gastrointestinal procedures appeared more likely to experience delayed postoperative feeding. Conclusions: Our findings demonstrate a gap between postoperative feeding evidence and its practical application. This information provides a strong rationale for interventions targeting improved nutritional care following surgery. [ABSTRACT FROM AUTHOR]

Background: The study aim was to establish and quantify suicide risk following acute admissions for all major physical illnesses, for confirmatory purposes, from two independent information sources from different countries. Methods: Record linkage of inpatient and death certificate data for 11 004 389 acute admissions for physical illnesses in England and 713 496 inWales. The main outcome measure was standardised mortality ratios (SMRs) for suicide at 1 year following discharge from hospital. Results: There were 1781 suicides within 1 year of discharge in England (SMR = 1.7; 95% = 1.6-1.8) and 131 in Wales (SMR = 2.0; 1.7-2.3). Of 48 major physical illnesses that were associated with at least eight suicides in either country, there was high consistent suicide mortality (significant SMR >3) in both countries for constipation (SMR = 4.1 in England, 7.5 in Wales), gastritis (4.4 and 4.9) and upper gastrointestinal bleeding (3.4 and 4.5). There was high suicide mortality in one country for alcoholic liver disease, other liver disease and chronic pancreatitis; for epilepsy and Parkinson's disease; for diabetes, hypoglycaemia and hypo-osmolality & hyponatraemia; and for pneumonia, back pain and urinary tract infections. Conclusions: There is little or no increased suicide mortality following acute admissions for most physical illnesses. Much of the increased suicide mortality relates to gastrointestinal disorders that are often alcohol related or specific chronic conditions, which may be linked to side effects from certain therapeutic medications. Acute hospital admissions for physical illnesses may therefore provide an opportunity for targeted suicide prevention among people with certain conditions, particularly alcohol related disorders. [ABSTRACT FROM AUTHOR]

Our objective was to determine the effect of castration timing, method, and use of the analgesic meloxicam (MEL) on inflammation, behavior, performance, and carcass traits in feedlot cattle. This study was a randomized complete block design conducted over a 3-yr period. In total, 194 crossbred beef calves from a single ranch origin were randomized at birth to receive one of five treatments arranged as a 2 × 2 + 1 factorial: 1) bulls castrated within 48 h of birth (CON), 2) bulls surgically castrated on day 0 without MEL (SUR), 3) bulls surgically castrated on day 0 with MEL (SUR + MEL), 4) bulls band castrated on d 0 without MEL (BAN), and 5) bulls band castrated on day 0 with MEL (BAN + MEL). Upon feedlot arrival (day -11; average 287 ± 2.03 d of age), animals were blocked by initial BW (224 ± 4.5 kg) and assigned randomly to treatment pens in three consecutive years (n = 2 pens per treatment in each year). Oral MEL was administered at 1 mg/kg BW concurrent with applicable castration treatment on day 0. Data were analyzed using the MIXED and GLIMMIX procedures of SAS with pen (year) serving as experimental unit. From days 0 to 7, ADG was reduced (P = 0.01) for surgical (-0.42) compared to band (0.43 kg/d) castration. Conversely, ADG was increased for surgical (1.74) vs. band (1.46 kg/d) castration from days 14 to 32. There was also an overall (day 0 to final) improvement in ADG for MEL (P = 0.02), but no effect of castration method was observed (P = 0.81). The CON group had the greatest (P = 0.05) marbling score. Backfat thickness was increased (P = 0.01) for MEL. A treatment × day interaction (P = 0.04) existed for serum haptoglobin, with SUR having the greatest (P < 0.01) concentration on days 1 and 4. Meloxicam administered in the surgically castrated treatment reduced (P = 0.01) serum haptoglobin concentration on day 1. Relative to baseline, standing duration for surgical castration was increased 113 min (P < 0.01), while banding caused 6.7 more lying bouts (P < 0.01) immediately following castration on day 0. Step count was greatest for BAN, intermediate for CON, and least for surgical (P < 0.01). Results suggest that MEL mitigated the more pronounced inflammation observed for surgical castration, whereas behavior was differentially altered for castration method indicative of a divergent pain response. Castration, regardless of method, transiently reduced ADG, but MEL administration improved overall ADG for both methods. [ABSTRACT FROM AUTHOR]

Background Little has been reported on mortality following admissions at weekends for many gastrointestinal (GI) disorders. The aim was to establish whether GI disorders are susceptible to increased mortality following unscheduled admission on weekends compared with weekdays. Methods Record linkage was undertaken of national administrative inpatient and mortality data for people in England and Wales who were hospitalized as an emergency for one of 19 major GI disorders. Results The study included 2 254 701 people in England and 155 464 in Wales. For 11 general surgical and medical GI disorders there were little, or no, significant weekend effects on mortality at 30 days in either country. There were large consistent weekend effects in both countries for severe liver disease (England: 26·2 (95 per cent c.i. 21·1 to 31·6) per cent; Wales: 32·0 (12·4 to 55·1 per cent) and GI cancer (England: 21·8 (19·1 to 24·5) per cent; Wales: 25·0 (15·0 to 35·9) per cent), which were lower in patients managed by surgeons. Admission rates were lower at weekends than on weekdays, most strongly for severe liver disease (by 43·3 per cent in England and 51·4 per cent in Wales) and GI cancer (by 44·6 and 52·8 per cent respectively). Both mortality and the weekend mortality effect for GI cancer were lower for patients managed by surgeons. Discussion There is little, or no, evidence of a weekend mortality effect for most major general surgical or medical GI disorders, but large weekend effects for GI cancer and severe liver disease. Lower admission rates at weekends indicate more severe cases. The findings for severe liver disease may suggest a lack of specialist hepatological resources. For cancers, reduced availability of end-of-life care in the community at weekends may be the cause. [ABSTRACT FROM AUTHOR]

Background Active patient involvement in nutrition care may improve dietary intakes in hospital. Our team is developing an innovative programme allowing patients to self-assess and self-monitor their nutrition at the bedside. The present study aimed to assess usability and patient perceptions of an electronic foodservice system ( EFS) for participating in nutrition care. Methods This qualitative study was conducted in an Australian tertiary hospital. Participants were sampled purposively and included patients who were able to provide informed consent and communicate in English. Patient interviews were conducted at the bedside and consisted of: (i) usability testing of the EFS using 'Think Aloud' technique and (ii) questioning using a semi-structured interview guide to understand perceptions of the EFS. Interview data were analysed using inductive content analysis. Results Thirty-two patients were interviewed. Their perceptions of using the EFS to participate in nutrition care were expressed in five categories: (i) Familiarity with technology can affect confidence and ability but is not essential to use EFS; (ii) User interface design significantly impacts EFS usability; (iii) Identifying benefits to technology increases its acceptance; (iv) Technology enables participation, which occurs to varying extents; and (v) Degree of participation depends on perceived importance of nutrition. Conclusions Patients found the EFS acceptable and acknowledged benefits to its use. Several factors appeared to influence usability, acceptability and willingness to engage with the system, such as user interface design and perceived ease of use, benefits and importance. The present study provides important insights into designing technology-based interventions for engaging inpatients in their nutrition care. [ABSTRACT FROM AUTHOR]

Aims To compare long-term HbA1c changes associated with different insulin pumps during routine care in a large cohort of adults with Type 1 diabetes representative of other clinic populations. Methods Observational, retrospective study of 508 individuals starting pump therapy between 1999 and 2014 (mean age, 40 years; 55% women; diabetes duration, 20 years; 94% Type 1 diabetes; median follow-up, 3.7 years). Mixed linear models compared covariate-adjusted HbA1c changes associated with different pump makes. Results The pumps compared were: 50% Medtronic, 24% Omnipod, 14% Roche and 12% Animas. Overall HbA1c levels improved and improvements were maintained during a follow-up extending to 10 years (HbA1c: pre-continuous subcutaneous insulin infusion (pre- CSII) vs. 12 months post CSII, 71 (61, 82) vs. 66 (56, 74) mmol/mol; 8.7 (7.7, 9.6) vs. 8.2 (7.3, 8.9)%; P < 0.0001). The percentage of individuals with HbA1c ≥ 64 mmol/mol (8.0%) reduced from a pre- CSII level of 68% to 55%. After adjusting for baseline confounders, there were no between-pump differences in HbA1c lowering ( P = 0.44), including a comparison of patch pumps with traditional catheter pumps ( P = 0.63). There were no significant ( P < 0.05) between-pump differences in HbA1c lowering in pre-specified subgroups stratified by pre-pump HbA1c, age or diabetes duration. HbA1c lowering was positively related to baseline HbA1c ( P < 0.001) and diabetes duration ( P = 0.017), and negatively related to the number of years of CSII use ( P = 0.024). Conclusions Under routine care conditions, there were no covariate-adjusted differences in HbA1c lowering when comparing different pump makes, including a comparison of patch pumps vs. traditional catheter pumps. Therefore, the choice of CSII make should not be influenced by the desired degree of HbA1c lowering. [ABSTRACT FROM AUTHOR]

Recent advances in embryo freezing technology together with growing concerns over multiple births have shifted the paradigm of appropriate IVF. This has led to the adoption of new performance indicators for ART clinics by national reporting schemes, such as those curated by the Society for Assisted Reproductive Technology (SART) and the Human Fertilization and Embryology Authority (HFEA). Using these organizations as case studies, we review several outcome measures from a statistical perspective. We describe several denominators that are used to calculate live birth rates. These include cumulative birth rates calculated from all fresh and frozen transfer procedures arising from a particular egg collection or cycle initiation, and live birth rates calculated per embryo transferred. Using data from both schemes, we argue that all cycles should be included in the denominator, regardless of whether or not egg collection and fertilization were successful. Excluding cancelled cycles reduces the impact of confounding due to patient characteristics but also removes policy and performance differences which we argue represent relevant sources of variation. It may be misleading to present prospective patients with essentially hypothetical measures of performance predicated on parity of ovarian stimulation and transfer policies. Although live birth per embryo has the advantage of encouraging single embryo transfer, we argue that it is prone to misinterpretation. This is because the likelihood of live birth is not proportional to the number of embryos transferred. We conclude that it is not possible to present a single measure that encompasses both effectiveness and safety. Instead, we propose that a set of clear, relevant outcome indicators is necessary to enable subfertile patients to make informed choices regarding whether and where to be treated. [ABSTRACT FROM AUTHOR]

Cardiac allograft rejection (AR) diagnosis has historically relied on endomyocardial biopsy (EMBx) and histopathology (HP). Quantifying donor-derived cell free DNA (ddcfDNA) has recently offered a non-invasive alternative for detecting graft injury. EMBx mRNA analysis via the molecular microscope profiles (MMP) quantifies AR probability not subject to HP interpretation. Our aim was to evaluate the clinical role of MMP in cardiac transplant recipients (HTx) with positive ddcfDNA. We identified 39 patients with ddcfDNA testing and subsequent EMBx for HP (n=36) and MMP (n=39) analysis. MMP was conducted by the molecular microscope diagnostic system (MMDX™). Patients with multi-organ transplantation or coronary allograft vasculopathy were excluded. MMP, HP, echo and ddcfDNA association were assessed using logistical regression (SPSS™). Average time post-transplant was 1585 ±1435 days, average LVEF 55%, and average ddcfDNA 0.81 ± 1.1. Donor specific antibodies were present in 14/39 of patients. MMP was abnormal in 18/39 patients and correlated with ddcfDNA levels (p=0.007) and HP (p=0.05), but not with LVEF (p=0.71). MMP abnormalities included 9 antibody mediated rejection (AMR), 5 acute cellular rejection (ACR), and 4 injury patterns. By HP, biopsies were abnormal in 18/36 patients: 18 ACR (grade 1) and 1 AMR (grade 2). Abnormal HP did not correlate with ddcfDNA levels (p= 0.07). HP and MMP are often discordant, Table 1. Abnormal MMP correlated with both ddcfDNA and HP, but not with LVEF. Large prospective clinical trials are needed to define clinical outcomes from treatment strategies based on biopsy results. Multi-modality testing may be necessary to monitor cardiac transplant patients for rejection and avoid misclassification. [ABSTRACT FROM AUTHOR]

Prompt detection of cardiac allograft rejection (AR) is essential for maintaining graft function, prevention of cardiac allograft vasculopathy and survival. Diagnosis has historically relied on endomyocardial biopsy (EMBx) with histopathological analysis, however this is subject to low early rejection sensitivity and inter-observer interpretation variability. Detection of donor derived cell free deoxyribose nucleic acid (ddcfDNA) in serum has recently been developed as a non-invasive alternative for AR detection. Our aim was to assess AR rate after adopting ddcfDNA for AR surveillance. This is a retrospective cohort study. Patients were excluded for positive crossmatch at transplant, multi-organ transplant and non-specific graft failure. Routine biopsies were done at weeks 1, 2, 3, 4 and 6. After week 6 routine screening with ddcfDNA replaced EMBx. A positive ddcfDNA (≥ 0.2) was considered an indication for biopsy. The number of EMBx decreased with utilization of ddcfDNA, Figure 1. Rejection rates have not increased with ddcfDNA surveillance, Figure 2. Implementation of ddcfDNA for AR surveillance eight weeks after cardiac transplantation reduced the number of EMBx by greater than 40% and was accompanied by no increase in one year rejection rate. Our data supports the integration of ddcfDNA in AR surveillance. Large prospective clinical trials are needed to define potential clinical benefits such as reduced procedural complication rates and preservation of allograft function from early AR detection. [ABSTRACT FROM AUTHOR]

Although the benefits of sacubitril/valsartan have been clearly defined in systolic heart failure (HF), a paucity of data is available to guide clinicians for patients with left ventricular assist devices (LVAD). No randomized clinical trials are available and utilization after implantation is inconsistent. We aimed to assess whether sacubitril/valsartan following LVAD implantation improves clinical outcomes. Retrospective analysis was performed on LVAD recipients between January 2016 - November 2020 at a large academic center. Sacubitril/valsartan tolerance > 30 days demarcated groups. HF admission incidence and mortality were assessed between groups. Change in mean arterial pressure (MAP) was assessed using a linear mixed model within the sacubitril/valsartan group. HF admission incidence was defined as the number of HF admissions while patients were on sacubitril/valsartan and was compared to HF admission incidence after LVAD implantation for the control group using negative binomial regression. Survival was assessed via Kaplan-Meier method and log rank test. The study cohort included 188 LVAD patients with 38 on sacubitril/valsartan for > 30 days. The sacubitril/valsartan group was a mean of 5 years younger, with all other baseline demographics statistically similar to the control group. Within the sacubitril/valsartan group at 6 months, MAP was reduced by 8 mmHg relative to pre LVAD values (p=0.01). Sacubitril/valsartan reduced HF admissions per patient-year from 3.27 in the control group to 0.56 in the sacubitril/valsartan group (p<0.0001). Overall number of hospitalizations was not different (p=0.75). A trend favoring improved survival was present in patients receiving sacubitril/valsartan (p=0.15). Sacubitril/valsartan reduced MAP and HF admissions, and a trend towards improved survival was present. Our data supports the use of sacubitril/valsartan post-LVAD implantation and the need for prospective trials in this population. [ABSTRACT FROM AUTHOR]

Background: There is no specific quality of life (QoL) measurement tool to quantify QoL in patients with biliary tract cancer. Quality of life measurement is an increasingly crucial trial end point and is now being incorporated into clinical practice.Methods: This International Multicentre Phase IV Validation Study assessed the QLQ-BIL21 module in 172 patients with cholangiocarcinoma and 91 patients with cancer of the gallbladder. Patients completed the questionnaire at baseline pretherapy and subsequently at 2 months. Following this, the psychometric properties of reliability, validity, scale structure and responsiveness to change were analysed.Results: Analysis of the QLQ-BIL21 scales showed appropriate reliability with Cronbach's α-coefficients >0.70 for all scales overall. Intraclass correlations exceeded 0.80 for all scales. Convergent validity >0.40 was demonstrated for all items within scales, and discriminant validity was confirmed with values <0.70 for all scales compared with each other. Scale scores changed in accordance with Karnofsky performance status and in response to clinical change.Conclusions: The QLQ-BIL21 is a valid tool for the assessment of QoL in patients with cholangiocarcinoma and cancer of the gallbladder. [ABSTRACT FROM AUTHOR]

Object:In recent conflicts, many UK personnel sustained head injuries requiring damage-control surgery and aeromedical transfer to the UK. This study aims to examine indications, complications and outcomes of UK military casualties undergoing craniectomy and cranioplasty from conflicts in Afghanistan and Iraq. Methods:The UK military Joint Theatre Trauma Registry (JTTR) was searched for all UK survivors in Afghanistan and Iraq between 2004 and 2014 requiring craniectomy and cranioplasty resulting from trauma. Results:Fourteen decompressive craniectomies and cranioplasties were performed with blast and gunshot wounds equally responsible for head injury. Ten survivors (71%) had an Injury Severity Score (ISS) of 75, normally designated as ‘unsurvivable’. Most were operated on the day of injury. Seventy-one percent received a reverse question mark incision and 7% received a bicoronal incision. Seventy-nine percent had bone flaps discarded. Overall infection rate was 43%.Acinetobacter sppwas the causative organism in 50% of cases. Median Glasgow Outcome Scale (GOS) at final follow-up was 4. All casualties had a GOS score greater than 3. Conclusions:Timely neurosurgical intervention is imperative for military personnel given high survival rates in those sustaining what are designated ‘un-survivable’ injuries. Early decompression facilitates safe aeromedical evacuation of casualties. Excellent outcomes validate the UK military trauma system and the stepwise performance gains throughout recent conflicts however trauma registers most evolving to have specific relevance to military casualties. In high-energy trauma with contamination and soft-tissue destruction, surgery should be conducted with regard for future soft tissue reconstruction. Bone flaps should be discarded and cranioplasty performed according to local preference. Facilities receiving military casualties should have specialist microbiological input mindful of the difficulties treating unusual microbes. [ABSTRACT FROM AUTHOR]

Color-in-context theory is the first theoretical framework for understanding color effects in human mate preferences, arguing that red clothing enhances attractiveness ratings. Here we present three empirical studies failing to support this prediction. We aimed to extend the current literature by differentiating color effects by temporal context (short-term vs. long-term mating). Experiment 1 involved Dutch participants rating a woman in red, white, and black on (sexual) attractiveness. Experiment 2 replicated the first experiment with an American sample. In the final experiment, we aimed to replicate a study that did find evidence of a red effect, using a substantially larger sample size. The results from each of the three studies (totaling N = 830 men) fail to support the red effect. We discuss the implications of our results and avenues for future research on red effects and attractiveness. [ABSTRACT FROM AUTHOR]

Reliable knowledge of manure nutrient content for intensive animal operations is imperative to development of effective comprehensive nutrient management plans, which will minimize nutrient runoff and pollution of adjacent waterways. The objectives of this study were to evaluate the spatial variation of manure dry-matter (DM), phosphorus (P), and nitrogen (N) content in commercial high-rise laying-hen houses, and to determine the sampling locations and number of samples that will lead to good assessment of nutrient content of manure in the houses. Two side-by-side manure samples were collected from 9 locations in each of 6 high-rise laying- hen houses (18 samples per house) and analyzed for DM, N, and P content. The 9 sample locations were distributed as one-fourth, half, and three-fourths of the building length, with 3 sample locations (every other manure row) per cross-section of the 5 manure rows. The average of DM, N, or P content from the 18 samples per house was used as the reference value for comparison of 8 sampling scenarios. Results showed that duplicate sampling at a location added little to the precision of the data. Manure samples collected crossways across the middle of the house or diagonally across the house in either direction yielded results most similar to the reference value for that house. Hence, when collecting manure samples for nutrient assessment in high-rise laying-hen houses, a single sample collected from every other manure pile across the middle of the building should be sufficient to obtain representative samples of the house and is recommended. [ABSTRACT FROM AUTHOR]

Study Question: Are female young cancer survivors (YCS) able to self-collect high-quality dried blood spots (DBSs) at home to provide biospecimens for studying ovarian reserve?Summary Answer: YCS can self-collect high-quality DBS specimens in non-clinical settings, and anti-Mullerian hormone (AMH) levels can be assayed in such specimens.What Is Known Already: Large-scale biosample collection is a barrier to studying ovarian reserve in YCS. DBS collected by research personnel has high acceptability. AMH levels measured in DBS are highly correlated with those measured by serum-based methods.Study Design, Size, Duration: In a prospective cohort study, YCS were recruited to self-collect DBS samples. AMH levels were assayed in 112 samples.Participants/materials, Setting, Methods: YCS participants, ages 18-44, were recruited from a nationwide longitudinal cohort and DBS collection materials were posted to them. AMH levels were assayed by the Ansh DBS AMH ELISA and compared according to participant characteristics.Main Results and the Role Of Chance: Among 163 potential participants, 123 (75%) were enrolled. Of those enrolled, 112 (91%) were able to complete DBS self-collection and submit mailed samples adequate for measuring AMH. Participants (mean age 31.6 [SD 5.5]) were 85% white, 87% college graduates and 46% reported higher income. Common cancer types were lymphoma and leukemia (34%), breast cancer (30%) and thyroid or skin cancer (8%). The geometric mean (95% confidence interval) AMH level in DBS samples was 0.24 ng/ml (0.16-0.36). In adjusted analysis, AMH levels for survivors of breast cancer (0.02 ng/ml [0.01-0.07]) or leukemia/lymphoma (0.03 ng/ml [0.01-0.08]) were lower than the levels in thyroid or skin cancer survivors (0.12 ng/ml [0.03-0.44]). Pelvic radiation remained associated with lower AMH levels (0.20 ng/ml [0.10-0.40] in unexposed versus 0.02 ng/ml [0.01-0.06] in exposed). Amenorrheic survivors had AMH levels (0.02 ng/ml [0.01-0.06]) that were lower than those of YCS with 7-9 (0.09 ng/ml [0.03-0.32]) or ≥10 (0.17 ng/ml [0.08-0.37]) menstrual periods in the past year.Limitations, Reasons For Caution: The results are generalizable to a population of highly educated, higher income YCS. It is unclear how generalizable the results are to other populations.Wider Implications Of the Findings: Self-collected DBS is a patient-friendly and minimally invasive tool for studying ovarian reserve in geographically diverse populations.Study Funding/competing Interests: Research related to the development of this paper was supported by the National Institutes of Health, grants UL1 RR024926 pilot and HD080952-02, and by the American Cancer Society MRSG-08-110-01-CCE. The authors report no competing interests. [ABSTRACT FROM AUTHOR]

The nonlinear and weakly dispersive Serre equations contain higher-order dispersive terms. These include mixed spatial and temporal derivative flux terms which are difficult to handle numerically. These terms can be replaced by an alternative combination of equivalent temporal and spatial terms, so that the Serre equations can be written in conservation law form. The water depth and new conserved quantities are evolved using a second-order finite-volume scheme. The remaining primitive variable, the depth-averaged horizontal velocity, is obtained by solving a second-order elliptic equation using simple finite differences. Using an analytical solution and simulating the dam-break problem, the proposed scheme is shown to be accurate, simple to implement and stable for a range of problems, including flows with steep gradients. It is only slightly more computationally expensive than solving the shallow water wave equations. [ABSTRACT FROM PUBLISHER]

Beneficial health properties of garlic, as well as its most common adverse effect - distinctive breath odour - are well-known. In contrast, analogous research on the effect of garlic on axillary odour is currently missing. Here, in three studies varying in the amount and nature of garlic provided (raw garlic in study 1 and 2, garlic capsules in study 3), we tested the effect of garlic consumption on the quality of axillary odour. A balanced within-subject experimental design was used. In total, 42 male odour donors were allocated to either a "garlic" or "non-garlic" condition, after which they wore axillary pads for 12 h to collect body odour. One week later, the conditions were reversed. Odour samples were then judged for their pleasantness, attractiveness, masculinity and intensity by 82 women. We found no significant differences in ratings of any characteristics in study 1. However, the odour of donors after an increased garlic dosage was assessed as significantly more pleasant, attractive and less intense (study 2), and more attractive and less intense in study 3. Our results indicate that garlic consumption may have positive effects on perceived body odour hedonicity, perhaps due to its health effects (e.g., antioxidant properties, antimicrobial activity). [ABSTRACT FROM AUTHOR]

Background There is little up-to-date review evidence on the prevalence of Helicobacter pylori across Europe. Aim To establish regional and national patterns in H. pylori prevalence across Europe. Secondly, to establish trends over time in H. pylori prevalence and gastric cancer incidence and, thirdly, to report on the relationship between H. pylori prevalence and age group across Europe. Methods A review of H. pylori prevalence from unselected surveys of adult or general populations across 35 European countries and four European regions since 1990. Secondly, an analysis of trends over time in H. pylori prevalence and in gastric cancer incidence from cancer registry data. Results Helicobacter pylori prevalence was lower in northern and western Europe than in eastern and southern Europe (P < 0.001). In 11 of 12 European studies that reported on trends, there were sharp reductions in H. pylori prevalence (mean annual reduction = 3.1%). The mean annual reduction in the incidence of gastric cancer across Europe from 1993 to 2007 was 2.1% with little variation regionally across Europe (north 2.2%, west 2.3%, east 1.9% and south 2.0%). Sharp increases in age-related prevalence of H. pylori often levelled off for middle age groups of about 50 years onwards, especially in areas with high prevalence. Conclusions This review shows that H. pylori prevalence is much higher in less affluent regions of Europe and that age-related increases in prevalence are confined to younger age groups in some areas. There were sharp reductions in both H. pylori prevalence and gastric cancer incidence throughout Europe. [ABSTRACT FROM AUTHOR]

Basaltic lava flows and ignimbrite units around Puerto de Santiago, SW Tenerife, were investigated as potential analogues for hydrocarbon-bearing volcanic reservoir rocks. Conventional helium porosity and air permeability measurements together with the results of a micro-focus X-ray computed tomography study were integrated with field observations on flow morphology and the continuity of defined internal lava flow zones. Individual lava flows typically comprise distinct tops, cores and bases, with lava piles showing repeated cycles of these three internal zones. Reservoir quality is best in the flow tops (mean ϕ = 23.14%, k = 5.622mD) where vesicular porosity dominates. Flow cores are relatively tight with primary porosity mainly controlled by cooling joints, fractures and intercrystalline microporosity (mean ϕ = 2.40%, k = 0.001mD). Flow bases show variable reservoir potential due to the presence of breccia and/or vesiculation (mean ϕ = 11.77%, k = 0.001mD). By contrast, ignimbrites show the highest porosities but have low permeabilities (mean ϕ = 35.64%, k = 0.0056mD). In all cases, the primary porosity and permeability may have been modified to create additional secondary porosity and permeability as a result of fracturing and mineral dissolution during burial or weathering, although porosity may also be occluded through the precipitation of secondary minerals or the alteration of primary minerals. The new porosity data presented demonstrates that pyroclastics and basaltic lava flow tops have the best reservoir properties, with the flow tops having sufficient porosity and permeability to transmit fluids and gas. In contrast, flow cores are relatively tight (impermeable), and would act as seals to potential hydrocarbon accumulations when fractures and cooling joints are absent. The reservoir potential can be high where vesicles and fractures are present (i.e. in lava flow tops), although there is uncertainty whether flow tops could be connected to each other vertically to form a potentially exploitable hydrocarbon reservoir. Although in some areas such volcanic rocks can be primary targets for hydrocarbon exploration (e.g. onshore China), in many others they are considered to be a secondary target, adding incremental resources to hydrocarbons produced from more conventional sandstone and carbonate reservoirs. [ABSTRACT FROM AUTHOR]

The use of ventricular assist devices has expanded significantly since their approval by the Food and Drug Administration in the United States in 1994. In addition to this, the prevalence of heart failure continues to increase. We aim to provide an overview of perioperative considerations and management of these patients for non-cardiac surgery. We performed a Medline search for the words "ventricular assist device," "Heartmate" and "HeartWare" to gain an overview of the literature surrounding these devices, and chose studies with relevance to the stated aims of this review. Patients with ventricular assist devices are presenting more frequently for surgery not related to their cardiac pathology. As the mechanically supported population grows, general anesthesiologists will be faced with managing these patients, possibly outside of the tertiary care setting. The unique challenges of this patient population can best be addressed by a thorough understanding of ventricular assist device physiology and a multidisciplinary approach to care. [ABSTRACT FROM AUTHOR]

Osteoid osteoma is a benign bone tumor, which represents approximately 10% of all benign bone tumors. When localized to the carpus, osteoid osteomas are most often seen in the scaphoid and capitate. Rarely, these tumors can also be observed in the trapezium. Given the infrequency with which osteomas are located in the trapezium and often nonspecific presenting symptoms, diagnosis of this tumor can be challenging and requires a high index of suspicion. [ABSTRACT FROM AUTHOR]

Previous research indicates that metabolism and fiber type of skeletal muscle is related to intramuscular lipid content. It is hypothesized that changes in skeletal muscle gene expression influence adipose tissue development. The objective of this study was to determine differences in the metabolism and intercellular signaling of skeletal muscle fibers within the same muscle group that could be responsible for the initiation of intramuscular adipose tissue development and differentiation. Longissimus dorsi muscle samples were collected from steers (n = 12; 385 d of age; 378 kg BW) grazing wheat pasture. Longissimus muscle samples were dissected under magnification and sorted into 3 categories based on visual stage of adipose tissue development: immature intramuscular adipose tissue (MM), intermediate intramuscular adipose tissue (ME), and mature intramuscular adipose tissue (MA). Additionally, muscle fibers lying adjacent to each intramuscular adipose tissue (IM) category and those not associated with IM tissue were collected and stored separately. Quantitative real-time PCR was used to determine relative fold change in genes involved in metabolism, angiogenesis, formation of extracellular matrix, and intercellular signaling pathways in both LM and IM samples. Gene expression data were analyzed using a GLM that included the fixed effect of tissue. Pearson correlation coefficients were also computed between gene expression in LM and IM tissue samples that were at the same stage of development. Fatty acid binding protein 4 and peroxisome proliferator-activated receptor δ mRNA expression were 3.56- and 1.97-fold greater (P < 0.05) in ME and MA IM compared with MM IM whereas delta-like 1 homolog mRNA expression was 1.43-fold less (P < 0.01) in MA IM compared with MM IM, indicating successful separation into different development categories. Genes associated with metabolism and angiogenesis in LM tissue showed no differences among stages of development. Myostatin expression did not change in LM tissue; however, expression of myostatin receptor and follistatin mRNA decreased (P < 0.01) as IM matured. Collagen type I and collagen type VI mRNA expression were 2.5- and 1.32-fold greater in LM associated with MM IM than in LM associated with ME IM. Angiogenic growth factors in MM IM tissue had a strong positive correlation (r = 0.69) with angiogenic growth factors in LM associated with MM IM; however, no correlation was observed in ME or MA IM. These data indicate a coordinated effort between LM and IM in early stages of IM development. [ABSTRACT FROM AUTHOR]

Background Malnutrition is common in hospitals and is a risk factor for pressure ulcers. Nutrition care practices relating to the identification and treatment of malnutrition have not been assessed in patients at risk of pressure ulcers. The present study describes nutrition care practices and factors affecting nutritional intakes in this patient group. Methods The study was conducted in four wards at two hospitals in Queensland, Australia. Adult patients at risk of pressure ulcers as a result of restricted mobility were observed for 24 h to determine their daily oral intake and practices such as nutrition screening, documentation and intervention. Independent samples t-tests and chi-squared tests were used to analyse dietary intake and nutrition care-related data. Predictors of receiving a dietitian referral were identified using logistic regression analyses. Results Two hundred and forty-one patients participated in the present study. The observed nutritional screening rate was 59% (142 patients). Weight and height were documented in 71% and 34% of cases. Sixty-nine patients (29%) received a dietitian referral. Predictors of receiving a dietitian referral included lower body mass index and longer length of stay. On average, patients consumed 73% and 72% of the energy and protein provided, respectively. Between 22% and 38% of patients consumed <50% of food provided at main meals. Conclusions Nutrition care practices including malnutrition risk screening and documentation of nutritional parameters appear to be inadequate in patients at risk of pressure ulcers. A significant proportion of these patients eat inadequately at main meals, further increasing their risk of malnutrition and pressure ulcers. [ABSTRACT FROM AUTHOR]

Pain management and welfare are increasingly prevalent concerns within animal agriculture. Analgesics may alleviate pain and inflammation associated with castration of beef cattle. This study was conducted to elucidate the effects of surgical castration on the acute inflammatory response and immunomodulation and whether concurrent oral administration of meloxicam (1 mg/kg BW) would alter these responses. On d -1, crossbred bull calves (n = 30; initial BW = 227.4 ± 10.3 kg) were fitted with indwelling jugular catheters and rectal temperature (RT) recording devices, placed into individual stanchions, and randomly assigned to 1 of 3 treatments. Treatment application occurred at h 0 and consisted of 1) intact bull calves treated with sham castration (CON), 2) bulls surgically castrated without meloxicam administration (CAS), and 3) bulls surgically castrated with oral meloxicam (1 mg/kg BW) administration (MEL). Blood samples were collected at 0.5-h intervals from h -2 to 4, 1.0-h intervals from h 4 to 8, and 12-h intervals from h 12 to 72. Serum was analyzed for cortisol and haptoglobin (Hp) concentrations using ELISA. Whole blood was analyzed for complete blood counts at -2, 0, 2, 4, 6, 8, 12, 24, 36, 48, 60, and 72 h, and RT was recorded in 5-min intervals. Postcastration RT was greatest for MEL (39.04), intermediate for CAS (38.99), and least for CON (38.93°C; P = 0.01). Serum cortisol was increased (P < 0.001) for CAS (12.3) and MEL (11.3) compared with CON (6.7 ng/mL) during the postcastration period. At 0.5 and 1.5 h, cortisol concentration was greater in CAS and MEL than CON, whereas at 2 and 2.5 h, cortisol concentration was greatest for CAS, intermediate for MEL, and least for CON (treatment × time, P < 0.001). Total white blood cell (P = 0.04), lymphocyte (P = 0.02), and monocyte (P = 0.002) counts were greatest for CAS, intermediate for MEL, and least for CON. Administration of MEL reduced (P = 0.002) eosinophil counts during the postcastration period when compared with CON and CAS. The change in serum Hp, relative to baseline values, was reduced for MEL at 36 (P < 0.01) and 60 h (P = 0.03), and the overall Hp concentration was least for MEL (P < 0.001). Oral administration of meloxicam at the time of castration reduced the acute inflammatory response in castrates, as evidenced by a reduction in Hp and certain leukocyte concentrations; it also caused a delayed increase in RT. Further research is needed to determine if this reduced acute inflammatory response would equate to improved health and/or performance after castration. [ABSTRACT FROM AUTHOR]

A variety of osteoarticular conditions possess an underlying genetic aetiology. Large-scale genome-wide association studies have identified several genetic loci associated with osteoarticular conditions, but were unable to fully account for their estimated heritability. Epigenetic modifications including DNA methylation, histone modification, nucleosome positioning, and microRNA expression may help account for this incomplete heritability. This articles reviews insights from epigenetic studies in osteoarticular diseases, focusing on osteoarthritis, but also examines recent advances in rheumatoid arthritis, osteoporosis, systemic lupus erythematosus (SLE), ankylosing spondylitis, and sarcoma. Genome-wide methylation studies are permitting identification of novel candidate genes and molecular pathways, and the pathogenic mechanisms with altered methylation status are beginning to be elucidated. These findings are gradually translating into improved understanding of disease pathogenesis and clinical applications. Functional studies in osteoarthritis, rheumatoid arthritis, and SLE are now identifying downstream molecular alterations that may confer disease susceptibility. Epigenetic markers are being validated as prognostic and therapeutic disease biomarkers in sarcoma, and clinical trials of hypomethylating agents as treatments for sarcoma are being conducted. In concert with advances in throughput and cost-efficiency of available technologies, future epigenetic research will enable greater characterisation and treatment for both common and rare osteoarticular diseases. [ABSTRACT FROM AUTHOR]

Background: In 2014, Louisiana passed a law requiring abortion providers to have hospital admitting privileges. This law is temporarily on hold while a court case challenging it continues. We aimed to describe the population who would be affected if the law goes into effect and how closures of between three and five Louisiana abortion facilities would affect the distance Louisiana women would need to travel for an abortion.Study Design: We abstracted patient data from three of the five Louisiana abortion care facilities in the year before the law was scheduled to take effect. We then estimated distance traveled and distances women would need to travel if clinics close.Findings: Half (53%) of women who had an abortion had no education beyond high school, most were black (62%) or white (30%), three fourths (73%) had a previous live birth, and most (89%) were having a first-trimester abortion. Seventy-nine percent resided in Louisiana and 15% in Texas. The parishes in which abortion patients resided had lower median income and higher percentage poverty than the Louisiana average. Abortion patients residing in Louisiana traveled a mean distance of 58 miles each way for an abortion. If all Louisiana facilities close, the mean distance women would need to travel would more than triple to 208 miles, and the proportion of Louisiana women of reproductive age who live more than 150 miles from an abortion facility would increase from 1% to 72%.Conclusion: The admitting privileges law will likely significantly increase the distance Louisiana women need to travel for an abortion. This burden is likely to disproportionately affect Louisiana's more vulnerable residents.Implications: If all Louisiana abortion facilities close due to Louisiana's hospital admitting privileges law, the mean distance women would need to travel for an abortion would more than triple from 58 to 208 miles. Louisiana's law would thus present a considerable burden on many Louisiana women, particularly those who are more vulnerable. [ABSTRACT FROM AUTHOR]

Objective:This study examined whether adopting a standardized prenatal substance use protocol (protocol) in a hospital labor and delivery unit reduced racial disparities in reporting to child protective services (CPS) related to maternal drug use during pregnancy.Study design:This study used an interrupted time series design with a non-equivalent control. One hospital adopted a protocol and another hospital group serving a similar geographic population did not change protocols. Data on CPS reporting disparities from these hospitals over 3.5 years were analyzed using segmented regression.Result:In the hospital that adopted the protocol, almost five times more black than white newborns were reported during the study period. Adopting the protocol was not associated with reduced disparities.Conclusion:Adopting a protocol cannot be assumed to reduce CPS reporting disparities. Efforts to encourage hospitals to adopt protocols as a strategy to reduce disparities may be misguided. Other strategies to reduce disparities are needed. [ABSTRACT FROM AUTHOR]

Hormonal fluctuation across the menstrual cycle explains temporal variation in women’s judgment of the attractiveness of members of the opposite sex. Use of hormonal contraceptives could therefore influence both initial partner choice and, if contraceptive use subsequently changes, intrapair dynamics. Associations between hormonal contraceptive use and relationship satisfaction may thus be best understood by considering whether current use is congruent with use when relationships formed, rather than by considering current use alone. In the study reported here, we tested this congruency hypothesis in a survey of 365 couples. Controlling for potential confounds (including relationship duration, age, parenthood, and income), we found that congruency in current and previous hormonal contraceptive use, but not current use alone, predicted women’s sexual satisfaction with their partners. Congruency was not associated with women’s nonsexual satisfaction or with the satisfaction of their male partners. Our results provide empirical support for the congruency hypothesis and suggest that women’s sexual satisfaction is influenced by changes in partner preference associated with change in hormonal contraceptive use. [ABSTRACT FROM PUBLISHER]

Background The British merchant fleet has expanded in recent years but it is not known whether this expansion has led to proportionate changes in mortality. Aims To investigate mortality from accidents and injuries in British merchant shipping, to determine whether this has increased in recent years, to compare fatal accident rates across British industries and to review fatal accident rates in merchant shipping worldwide over the last 70 years. Methods Examinations of marine accident investigation files, death registers and death inquiry files, national mortality statistics, worldwide surveys and review methodology. The main outcome measure was the fatal accident rate per 100 000 worker-years. Results Of 66 deaths in British shipping from 2003 to 2012, 49 were caused by accidents, which largely affected deck ratings. The fatal accident rate in British shipping increased by 4.7% per annum from 2003, although this was not significant (95% confidence interval: −5.1 to 15.6%). During 2003–12, the fatal accident rate in shipping (14.5 per 100 000) was 21 times that in the general British workforce, 4.7 times that in the construction industry and 13 times that in manufacturing. Of 20 merchant fleets worldwide with population-based fatal accident rates, most have shown large reductions over time. Conclusions The expansion of the British merchant fleet in recent years does not appear to have had a major impact on fatal accidents. Further preventive measures should target fatalities during mooring and towing operations. Internationally, most shipping fleets have over time experienced large decreases in fatal accident rates. [ABSTRACT FROM PUBLISHER]

Objectives: The practice of 'suicide audit' refers to the systematic collection of local data on suicides in order to learn lessons and inform suicide prevention plans. Little is known about the utility of this activity. The aim of this study was to ascertain from Directors of Public Health in England how they were conducting suicide audit and what resources they were investing in it; how the findings were being used, and how the process might be improved. Study design: E-mail survey. Methods: A questionnaire was sent to all 153 Primary Care Trusts (PCTs) in England prior to their dissolution in 2013. Simple descriptive statistics were performed in an Excel database. Results: Responses were received from 49% of PCTs, of which 83% were conducting a regular audit of deaths by suicide. Many had worked hard to overcome procedural obstacles and were investing huge amounts of time and effort in collecting data, but it is not clear that the findings were being translated effectively into action. With few exceptions, PCTs were unable to demonstrate that the findings of local audits had influenced their suicide prevention plans. Conclusions: In the light of fresh calls for the practice of suicide audit to be made mandatory in England, these results are worrying. The study suggests that there is a pressing need for practical guidance on how the findings of local suicide audits can be put to use, and proposes a framework within which such guidance could be developed. [ABSTRACT FROM AUTHOR]

Objective:This study compared the performance of two new bone-anchored hearing aids with older bone-anchored hearing aids that were not fully digital.Methods:Fourteen experienced bone-anchored hearing aid users participated in this cross-over study. Performance of their existing bone-anchored hearing aid was assessed using speech-in-noise testing and questionnaires. Participants were then fitted with either a Ponto Pro or a BP100 device. After four weeks of use with each new device, the same assessments were repeated.Results:Speech-in-noise testing for the 50 per cent signal-to-noise ratio (the ratio at which 50 per cent of responses were correct) showed no significant differences between the Ponto Pro and the BP100 devices (p = 0.1) However, both devices showed significant improvement compared with the participants' previous bone-anchored hearing aid devices (p < 0.001). There were no significant differences between the two new devices in the questionnaire data.Conclusion:Both fully digital bone-anchored hearing aids demonstrated superior speech processing compared with the previous generation of devices. There were no substantial differences between the two digital devices in either objective or subjective tests. [ABSTRACT FROM AUTHOR]